Efficacy and Safety of Paracetamol for Patent Ductus Arteriosus Closure in Preterm Infants: An Updated Systematic Review and Meta-Analysis

Frontiers in Pediatrics

article

Yingqi Xiao¹  Hui Liu²  Rujun Hu¹  Qiang You³  Min Zeng⁴  Xiaolian Jiang¹ 

[1] West China School of Nursing/ West China Hospital, Sichuan University;Key Laboratory of Birth Deficits and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University;Department of Pharmacy, Chengdu University of Traditional Chinese Medicine;Department of Pharmacy, West China Second University Hospital, Sichuan University

关键词: ductus arteriosus;    patent;    infant;    premature;    paracetamol;    ibuprofen;    indomethacin;   

DOI  :  10.3389/fped.2019.00568

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Indomethacin and ibuprofen, two commonly used prostaglandin inhibitors, are the drugs of choice for patent ductus arteriosus. However, paracetamol is an alternative choice when these drugs are ineffective or contraindicated. This study aimed to confirm paracetamol's efficacy and safety compared with those of other drugs or placebos for patent ductus arteriosus closure in premature infants. Methods: We conducted a literature search using the Cochrane Library, PubMed, CINAHL, and EMBASE databases for randomized controlled trials and quasi-randomized controlled trials. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to direct the process and PICO (P, population; I, intervention/interest; C, comparator; O, outcome) principle to constitute the theme. We combined the research data through qualitative summaries or meta-analyses. Results: The final analyses included 15 trials ( N = 1,313). No significant differences were noted between paracetamol and ibuprofen except for shorter mean days needed for patent ductus arteriosus closure, lower risk of gastrointestinal bleeding, and hyperbilirubinemia. No significant difference existed between paracetamol and indomethacin. Oral paracetamol was more effective than placebo in infants weighing 1,501–2,500 g. Conclusions: Our study findings tentatively conclude that paracetamol can induce early patent ductus arteriosus closure without significant side effects but that its efficacy is not superior to that of indomethacin.

【 授权许可】

CC BY