Can Paracetamol Be Used As The First-line Treatment For Patent Ductus Arteriosus in Preterm Infants?

INTRODUCTION: To evaluate reliability and effectiveness of paracetamol therapy in medical closure of patent ductus arteriosus (PDA).
METHODS: A total of 11 preterm infants with hemodynamically significant PDA detected who received oral or intravenous paracetamol therapy as the first line treatment were retrospectively evaluated in this study. One cure of paracetamol therapy was administered as 60 mg/kg/day (4 doses, 3 days). Post-treatment echocardiographic and laboratory findings of the subjects were assessed.
RESULTS: The study included 11 preterm infants with a gestational age of 24-29 weeks. The closure of ductus was achieved following the first cure of treatment in 2 of 3 infants administered oral paracetamol therapy and in 5 of 8 infants given intravenous paracetamol therapy. After two cures of paracetamol therapy, ductus was closed in all infants who received oral or intravenous paracetamol therapy. Re-opening was not detected in either group. No side effect was noted due to paracetamol therapy during the treatment.
DISCUSSION AND CONCLUSION: Oral or intravenous paracetamol therapy which is an inexpensive, easily accessible and effective treatment method with less side effects can be used for medical closure of PDA as the drug of first choise.In order to generalize the conclusions further randomized,controlled trials are warranted.