THE EFFICACY, SIDE-EFFECTS, AND MORTALITY COMPARISON BETWEEN PARACETAMOL AND IBUPROFEN IN PATENT DUCTUS ARTERIOSUS TREATMENT FOR PREMATURE INFANTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, have long been a standard pharmacotherapy for patent ductus arteriosus (PDA). However, recently, paracetamol has also proven to produce the same effect by preventing prostaglandin synthesis. Several studies have compared the efficacy and side-effects of both drugs, but the results are not straightforward. The meta-analysis aims to compare the efficacy, side effects, and mortality of ibuprofen and paracetamol for treatment of PDA in preterm infants. Relevant articles were searched for on PubMed, Clinical Key, EMBASE, Cochrane Database, and Google Scholar before the study’s quality was assessed using the Jadad criteria and the data were analyzed using Review Manager. Fifteen clinical studies with 1477 preterm infants as the samples were analyzed using a meta-analysis. No significant statistical difference was found between the efficacy of paracetamol and ibuprofen in the DA closure and mortality cases. Meanwhile, for oliguria, kidney disease, and gastrointestinal bleeding, significant statistical difference was found with a lower risk in paracetamol.

Keywords

• ibuprofen
• paracetamol
• patent ductus arteriosus
• preterm