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Is paracetamol safe and effective for ductus arteriosus closure?
  1. Maryann Mazer-Amirshahi1,2,
  2. John van den Anker2,3
  1. 1Department of Emergency Medicine, The George Washington University, Washington, DC, USA
  2. 2Department of Clinical Pharmacology, Children's National Medical Center, Washington, DC, USA
  3. 3Department of Pediatrics, The George Washington University, Washington, DC, USA
  1. Correspondence to Dr Maryann Mazer-Amirshahi, Department of Clinical Pharmacology, Children's National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010, USA; maryannmazer{at}gmail.com

https://doi.org/10.1136/archdischild-2013-304630

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    Dr Allegaert and colleagues wrote an outstanding review of the literature regarding the use of paracetamol to induce patent ductus arteriosus (PDA) closure.1 However, their discussion of the significant safety and efficacy concerns and the need for additional data was limited. It is important for the readership of the journal to be provided with more detailed information before paracetamol therapy is incorporated into routine clinical practice.

    It has been recognised that persistence of PDA is associated with increased morbidity and mortality in preterm infants.1 Infants with a clinically relevant PDA are commonly treated with cyclooxygenase (COX) inhibitors such as indomethacin or ibuprofen, yet these agents are …

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