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A Comparative Study of the Effects of Intravenous Indomethacin and Oral Mefenamic Acid in the Treatment of Premature Infants with Patent Ductus Arteriosus

Journal of the Korean Pediatric Society 2001;44(1):32-39.
Published online January 15, 2001.
A Comparative Study of the Effects of Intravenous Indomethacin and Oral Mefenamic Acid in the Treatment of Premature Infants with Patent Ductus Arteriosus
Hae Jung Park1, Yoon Suk Jung1, Nam Soo Kim1, Chang Ryul Kim1, Hyuk Kim2, Soo Jee Moon1
1Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
2Department of Thoracic Surgery, College of Medicine, Hanyang University, Seoul, Korea
미숙아의 동맥관 개존증 치료에 있어서 정주 Indomethacin과 경구 Mefenamic acid의 효과 비교
박해정1, 정윤숙1, 김남수1, 김창렬1, 김 혁2, 문수지1
1한양대학교 의과대학 소아과학교실
2한양대학교 의과대학 흉부외과학교실
Abstract
Purpose
: For the management of patent ductus arteriosus(PDA) in premature infants, fluid restriction, correction of anemia, mechanical ventilation, diuretics, and surgery have been used, and the closure rate of PDA has improved significantly since the introduction of indomethacin and mefenamic acid as pharmacologic treatments of PDA. We studied to evaluate and compare the therapeutic effects of indomethacin and mefenamic acid in the management of premature infants with PDA.
Methods
: 32 inborn premature infants who were hospitalized in NICU and diagnosed as PDA by cardiac sector were retrospectively studied and divided into two groups : An indomethacin treated group and a mefenamic acid treated group. Their gestational age, birth weight, blood urea nitrogen(BUN), creatinine(Cr), platelet count, urine output, fluid therapy, postnatal age, closure rate of PDA, and etc. were examined and conpared through the medical record review.
Results
: The mean postnatal age on drug use was 4.6 days in intravenous indomethacin treated group(n=18), 9.0 days in oral mefenamic acid treated group(n=14), and the mean gestational age was 32.0 weeks and 32.3 weeks, respectively. After the use of each drugs, platelet count and urine output decreased, whereas blood urea nitrogen and creatinine increased. The closure rate of PDA was 94.4%(17/18) in the indomethacin treated group and 85.7%(12/14) in the mefenamic acid treated group(P=0.568). On the multivariate analysis except for the drugs, the most significant factor on PDA closure in preterm neonates was total amount of intake(P=0.000).
Conclusion
: We conclude that intravenous indomethacin is as effective as oral mefenamic acid in the therapy of preterm infants with PDA.
Key Words: Indomethacin, Mefenamic acid, Patent ductus arteriosus, Premature infant


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