A Comparison between the Safety and Efficacy of IV Paracetamol (Acetaminophen) and IV Ibuprofen in Treating Premature Neonates with Patent Ductus Arteriosus (PDA)

Background: Patent Ductus Arteriosus (PDA) is a common Congenital Heart Disease (CHD) that can lead to infant mortality. This study compared the impact of two treatment approaches (i.e. intravenous acetaminophen and ibuprofen) on the closure rate of PDA. Methods: In this randomized controlled trial, 30 infants with PDA were divided into two groups based on the applied treatment approaches (IV acetaminophen and IV ibuprofen). The two groups were compared with each other in terms of primary outcomes including post-intervention PDA grades, length of stay, duration of mechanical ventilation, and patient outcomes (i.e. death or discharge). Results: Based on the results, none of the participants had a moderate or large-sized PDA after the intervention. The post-intervention PDA closure rates in the acetaminophen and ibuprofen groups were 87.5 and 92.1%, respectively (p=0.626). The mortality rate in the acetaminophen and ibuprofen groups were 12.5 and 14.3%, respectively (p=0.886). In addition, no significant difference was found between the two groups in terms of the length of stay and duration of mechanical ventilation (p 0.05). Conclusion: The results showed that the efficacy of IV acetaminophen was similar to that of IV ibuprofen in the treatment of PDA. However, conducting randomized multicenter clinical trials with larger sample sizes is recommended to confirm the replacement of IV ibuprofen by acetaminophen.