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http://dx.doi.org/10.3345/kjp.2008.51.9.956

The pharmacological treatment of patent ductus arteriosus in premature infants with respiratory distress syndrome: oral ibuprofen vs. indomethacin  

Lee, Soo Jin (Department of Pediatrics, Ewha Womans University, School of Medicine)
Kim, Ji Young (Department of Pediatrics, Ewha Womans University, School of Medicine)
Park, Eun Ae (Department of Pediatrics, Ewha Womans University, School of Medicine)
Sohn, Sejung (Department of Pediatrics, Ewha Womans University, School of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.51, no.9, 2008 , pp. 956-963 More about this Journal
Abstract
Purpose : Indomethacin is widely used for the prophylaxis and treatment of patent ductus arteriosus (PDA); however, it is associated with side effects such as renal failure, intraventricular hemorrhage, and gastrointestinal bleeding. Intravenous ibuprofen has been shown to be as effective as indomethacin in prompting PDA closure. If treatment with oral ibuprofen is as effective as indomethacin, it would have the advantages of greater availability, simpler administration, and lower cost. We conducted this study to compare the efficacy and side effects of indomethacin with those of oral ibuprofen, vis-$\grave{a}$-vis on the pharmacological closure of PDA. Methods : As a randomized double-blind study, 34 preterm infants with respiratory distress syndrome and hemodynamically significant PDA were treated with either intravenous indomethacin or oral ibuprofen. Echocardiography was performed by one cardiologist who was blind to the treatment that any given infant received. The rate of ductal closure, the need for additional drug treatment or surgical ligation, clinical outcome, and the side effects of drug treatment were compared. Results : Ductal closure occurred in 16 of 18 patients (88.9%) from the indomethacin group and in 14 of 16 patients (87.5%) from the ibuprofen group (P>0.05). Three patients in the indomethacin group and four in the ibuprofen group required a second drug treatment (P>0.05). Three patients (i.e., one patient in the indomethacin group and two in the ibuprofen group) underwent surgical ligation (P>0.05). Between the two groups, there was no significant difference vis-$\grave{a}$-vis in side effects or clinical outcome. Conclusion : Compared to indomethacin, oral ibuprofen has the advantages of simpler administration and lower cost, while being as effective; in addition, there are no differences between the two drug treatments with regards to side effects or clinical outcomes. Therefore, the widespread use of oral ibuprofen should be considered in treating PDA in preterm infants.
Keywords
Ibuprofen; Indomethacin; Patent ductus arteriosus; Respiratory distress syndrome;
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Times Cited By KSCI : 1  (Citation Analysis)
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