Treatment of patent ductus arteriosus with ibuprofen

Aim—To evaluate the eYciency and side eVects of ibuprofen for the early treatment of patent ductus arteriosus (PDA)and compare it with indomethacin. Methods—Forty preterm infants with gestational ages of less than 33 weeks, with respiratory distress syndrome (RDS) and echocardiographically confirmed PDA, were randomly assigned at days 2 to 3 of life to receive either intravenous indomethacin 3 × 0.2 mg/kg at 12 hour intervals or intravenous ibuprofen 1 × 10 mg/kg,followed by 5 mg/kg 24 and 48 hours later. Results—PDA closed in 15 of 20 patients from the indomethacin group (75%) and in 16 of 20 (80%) from the ibuprofen group. Seven patients (three indomethacin, four ibuprofen) required a second treatment with indomethacin and infive (three in the indomethacin group and two in the ibuprofen group) the duct was ultimately ligated. Ibuprofen patients had a better urinary output and showed no increase in serum creatinine concentrations compared with the indomethacin group. Ibuprofen was not associated with any other side eVect. Conclusions—Ibuprofen treatment seems to be as eYcient as indomethacin in closing PDA on the third day of life in preterm infants with respiratory distress syndrome and seems to have fewer renal side eVects. (Arch Dis Child 1997;76:F179‐F184)