Emerging treatments
Paracetamol
Paracetamol has been investigated as an alternative pharmacological treatment to indometacin or ibuprofen in preterm infants. One systematic review found no significant difference in PDA closure rates between paracetamol and ibuprofen or indomethacin; however, paracetamol caused fewer adverse effects, with a significantly reduced risk of oliguria and a tendency towards less gastrointestinal bleeding.[94] Another systematic review found a lack of high quality evidence to recommend paracetamol as a primary treatment for PDA.[95]
[ 
]
An overview of 16 Cochrane Reviews found that all available drug therapies, that is, indomethacin, ibuprofen, and paracetamol (specifically when given early), were effective in closing a PDA in preterm infants. The evidence on the effect of prophylactic paracetamol on severe intraventricular haemorrhage (IVH) was very uncertain (whereas indomethacin and ibuprofen were both found to reduce severe IVH).[53] Further study is warranted before paracetamol can be adopted as the standard of care.[57][59]
Use of this content is subject to our disclaimer