title: Effectiveness and safety of indomethacin versus ibuprofen for the treatment of patent ductus arteriosus in preterm infants.
abstract: OBJECTIVE
  To compare the incidence of medical closure of patent ductus arteriosus (PDA) and adverse events (acute renal dysfunction, necrotizing enterocolitis, spontaneous intestinal perforation, and gastrointestinal bleeding) between preterm infants who received indomethacin and ibuprofen for the treatment of PDA.
  
  
  METHODS
  A retrospective comparative effectiveness evaluation study was conducted on preterm infants (≤32 weeks) who received indomethacin or ibuprofen for treatment of symptomatic PDA.
  
  
  RESULTS
  Of the 124 eligible infants, 54 received indomethacin and 70 received ibuprofen. The overall incidence of medical PDA closure with indomethacin was 37/54 (68.5%) as compared with 42/70 (60%) in the ibuprofen group (p = 0.32). The proportion of infants with surgical PDA ligation was similar between the two groups (18.5% in both the groups). There was no difference in the incidences of acute renal dysfunction, necrotizing enterocolitis stage ≥ 2, spontaneous intestinal perforation, and gastrointestinal bleeding between indomethacin and ibuprofen groups.
  
  
  CONCLUSIONS
  Ibuprofen is as effective as indomethacin in the treatment of symptomatic PDA in preterm infants. This study also shows that both agents have similar adverse effects and the choice of one agent over the other should be based on local availability and dosing preference.
authors: Section of Neonatology, Department of Pediatrics, University of Calgary, Calgary, Canada.
authors: Sindhu
authors: S
authors: Sivanandan
authors: Varun
authors: V
authors: Bali
authors: Amuchou Singh
authors: AS
authors: Soraisham
authors: Andrei
authors: A
authors: Harabor
authors: Majeeda
authors: M
authors: Kamaluddeen
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy* / Q000601:surgery; D020345:Enterocolitis, Necrotizing / Q000139:chemically induced; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects / Q000627:therapeutic use*; D007213:Indomethacin / Q000009:adverse effects / Q000627:therapeutic use*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D007416:Intestinal Perforation / Q000139:chemically induced; D008297:Male; D051437:Renal Insufficiency / Q000139:chemically induced; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen; D007213:Indomethacin