The Effect of Rectal Acetaminophen on the Closure of Ductus Arteriosus in Premature Neonates: A Case Series Study

Background: Patent Ductus Arteriosus (PDA) with 30% prevalence is regarded as a common and threatening condition in premature neonates. Objectives: The present study aimed to assess the effect of rectal acetaminophen on PDA treatment in premature neonates. Methods: This case series study was conducted on all premature neonates with PDA admitted in Neonatal Intensive Care Unit (NICU) in Dr. Mohammad Kermanshahi Hospital affiliated to Kermanshah University of Medical Sciences (KUMS) during one year (2017). The subjects had contraindications for simultaneous administration of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and oral medications. Finally, 18 neonates (nine males and nine females) were studied. The patients were treated with 25 mg/kg rectal acetaminophen as the loading dose followed by 15 mg/kg/8 h for three days. Diagnosis and correction of PDA before and after the treatment were justified by echocardiography. Finally, statistical analyses were performed using chi-square and Mann-Whitney tests. Results: About 95% of the neonates responded to the treatment, while the response rate for oral ibuprofen and oral acetaminophen was 70 - 75% based on the results of the previous studies. The results indicated no statistically significant relationships among gestational age, birth weight, and the time of using rectal acetaminophen in two treatment steps of the study (P values = 0.898, 0.281, and 0.219, respectively). Conclusion: Rectal acetaminophen is suggested as an influential, safe, and cost-effective therapeutic option for PDA closure in preterm neonates with gestational age < 35 weeks.