Paracetamol for the Treatment of Patent Ductus Arteriosus in Very Low Birth Weight Infants

Persistent patent ductus arteriosus (PDA) is associated with significant co-morbidities and increased mortality in preterm infants, especially very low birth weight (VLBW) infants. A large number of studies on the management of PDA have been published. Despite PDA being such a common condition in preterm infants, there is no consensus on which PDAs to treat, when to treat and how best to treat. Nonspecific cyclo-oxygenase inhibitors such as indomethacin and ibuprofen have been the mainstay of medical treatment of PDA for decades. Ibuprofen has similar efficacy and higher safety profile when compared to indomethacin, as it is associated with fewer gastrointestinal and renal side effects, and is considered the drug of choice for PDA closure. Recently, there is a growing interest in paracetamol for PDA closure and it has been suggested as an alternative drug to treat PDA. Finding the optimal pharmacological treatment for PDA closure in VLBW continues to remain challenging. In this review article, we assessed the evidence of paracetamol for PDA closure VLBW infants.