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The effects of ibuprofen and indomethacin therapy for patent ductus arteriosus in preterm infants

Korean Journal of Pediatrics 2006;49(12):1315-1323.
Published online December 15, 2006.
The effects of ibuprofen and indomethacin therapy for patent ductus arteriosus in preterm infants
Wooksun Choi, Jung-Yeon Shin, Byung Min Choi, Baik-Lin Eun, Kee Hwan Yoo, Young Sook Hong, Joo Won Lee
Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
미숙아 동맥관 개존 치료에서 indomethacin과 ibuprofen의 효과
최욱선, 신정연, 최병민, 은백린, 유기환, 홍영숙, 이주원
고려대학교 의과대학 소아과학교실
Correspondence: 
Young Sook Hong, Email: yshong23@hanmail.net
Abstract
Purpose
: This study was conducted to compare the efficacy and safety of ibuprofen and indomethacin in the treatment of patent ductus arteriosus (PDA) in preterm infants and to determine whether ibuprofen can be an alternative drug.
Methods
: A total of 32 preterm infants with symptomatic PDA were enrolled in the study. Twelve infants received intravenous ibuprofen 10 mg/kg, followed by 5 mg/kg after 24 and 48 hours. As a comparative group, twenty premature infants received three doses of indomethacin 0.1-0.2 mg/kg every 12 hours.
Results
: PDA was closed in 11 of 12 infants of the ibuprofen group (92 percent) and in 18 of 20 infants of the indomethacin group (90 percent). Serum sodium concentration decreased along with time significantly (P<0.0001) and to its lowest level at 48 hours after administration of the third dose (P=0.0011) in both groups, but showed no significant difference between two groups. Serum BUN and creatinine concentrations were not changed significantly before or after treatment in each group and showed no difference between thetwo groups. The amount of urine output did not change along with time significantly in both groups (P=0.0725), and showed no significant difference between two groups.
Conclusion
: Ibuprofen has similar effects to indomethacin in the rate of PDA closure and complication when compared. It has similar changes in serum sodium level and complications when compared to indomethacin for the treatment of PDA in preterm infants. Therefore, intravenous ibuprofen may be used as an alternative agent in the treatment of symptomatic PDA in preterm infants.
Key Words: Ibuprofen , Indomethacin , Patent ductus arteriosus


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