Clinical Response of Paracetamol versus Indomethacin in the Medical Treatment of Patent Ductus Arteriosus in Newborn.

Patent Ductus Arteriosus (PDA) is a common acyanotic congenital heart disease in newborn which has a lot of serious consequences if left untreated. By giving proper medication timely, we can limit its complications. Already established drug 'Indomethacin' has demonstrated good effects but with many contraindications and potential adverse effects. Hence, the search for alternative drug for PDA is now a need of time. So, the objective of the study is to compare the clinical response of paracetamol and indomethacin in the medical treatment of PDA in newborn. This randomized controlled trial was carried out in the Department of Neonatology, Mymensingh Medical College Hospital, Bangladesh from October 2016 to February 2019. The study included sixty (60) cases of PDA, which were divided into two groups: the paracetamol group and the indomethacin group. Both drugs were found as equally effective in respect to PDA closure. The paracetamol group's PDA closure rate was 85.7%, whereas the indomethacin group's was 85.2%. More increase of serum creatinine and serum bilirubin and reduction of platelet count were observed in indomethacin group after intervention but these differences were not statistically significant (p>0.05). Paracetamol was found as safer than indomethacin and the frequency of complications including renal impairment, gastrointestinal bleeding, necrotizing enterocolitis were found more in indomethacin group. According to the results of this study, enteral paracetamol is safer than indomethacin yet just as effective in treating PDA closure in neonates.