Background and Aim The aim of this study was to evaluate the efficacy of paracetamol in preterm infants with patent ductus arteriosus (PDA) who failed to respond to ibuprofen treatment and/or for whom treatment with ibuprofen was contraindicated.
Methods Preterm infants with PDA who were ibuprofen-resistant and/or for whom ibuprofen treatment was contraindicated were started on paracetamol treatment with parental consent. Paracetamol was administered at a dose of 60 mg/kg/day, in 4 divided doses, for a period of 3–7 days. In the absence of closure of PDA, treatment was extended up to 7 days, after which repeat echocardiographic examination was performed.
Results A total of 8 preterm infants were included in the study with a median gestational age of 28.5 weeks (minimum-maximum: 234/7–365/7) and a median birth weight of 995 grams (range 630–2970). The first dose of paracetamol was given after a median of 9.5 days (range 5–27), for a median duration of 5 days (range 3–7). Median PDA diameter was 2.3 (range 2–3.5). Paracetamol resulted in successful closure of PDA in 7 (87.5%) patients, while 1 patient (12.5%) did not respond to treatment.
Conclusions To date, our case series is the largest to evaluate the efficacy of paracetamol for the management of PDA. We believe that paracetamol could be used as an alternative for infants who are either ibuprofen-resistant or for whom ibuprofen is contraindicated. Further prospective randomized-controlled trials are needed to evaluate the efficacy of paracetamol for the closure of PDA.