Objective:

To compare the efficacy and safety of acetaminophen versus ibuprofen for the treatment of patent ductus arteriosus (PDA) in newborn preterm.

Material and methods:

Systematic review that included randomized clinical trials (RCTs) that compared the efficacy and safety for PDA closure in neonates, between acetaminophen and ibuprofen. RCTs were searched in electronic databases. The selection, data extraction and quality assessment of included studies were done independently by two reviewers.

Results:

Of 454 potential articles, six RCTs were selected. The sum of the six studies was 733 participants (n = 371 with acetaminophen and n = 362 with ibuprofen). The closure of PDA was similar between the two drugs (87.3% and 84.5%, respectively) so there was no statistical difference, RR = 1.04; CI95%: 0.99-1.09. For safety, in general, no differences were found in the variables studied with the exception that the incidence of gastrointestinal bleeding was lower with acetaminophen (RR = 0.28; 95% CI: 0.11-0.73).

Conclusion:

Acetaminophen orally is comparable in effectiveness to oral ibuprofen for PDA closure of preterm infants, with reduced risk of gastrointestinal bleeding.

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