{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T19:03:44Z","timestamp":1793387024066,"version":"4.5.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T00:00:00Z","timestamp":1680566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Acetaminophen has gained interest in the neonatal community for its use in the management of hemodynamically significant patent ductus arteriosus (HsPDA) in preterm infants. We conducted a systematic review of randomized controlled trials (RCTs) comparing the efficacy and safety of acetaminophen with indomethacin for the management of HsPDA in preterm infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched PROSPERO, OVID Medline, OVID EMBASE, Wiley Cochrane Library (CDSR and Central), EBSCO CINAHL, and SCOPUS from inception to June 15, 2021. Bibliographies of identified studies were searched for additional references. Data were analyzed with Review Manager (RevMan) Version 5.3.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Four RCTs were identified, enrolling a total of 380 subjects. There was no difference between the interventions for the outcome of PDA closure after one course (RR 1.04 [95% CIs: 0.84, 1.29], P-value 0.70) or after two courses of treatment (RR 1.01 [95% CIs: 0.92, 1.12], P-value 0.77); and for the outcome of PDA ligation (RR 1.56 [95% CIs: 0.48, 5.12], P-value 0.46). However, patients who received acetaminophen had lower rates of necrotizing enterocolitis (RR 0.37 [95% CIs: 0.14, 0.95], P-value 0.04). There were no significant differences noted in the other clinical outcomes, that is, intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity requiring treatment, and death. Two studies noted significant post-treatment elevation of serum creatinine and blood urea with indomethacin, as compared to none with acetaminophen use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Acetaminophen has comparable efficacy to indomethacin for the outcome of HsPDA closure, with a better safety profile, that is, lesser rates of necrotizing enterocolitis and post-treatment azotemia noted with its use.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pch\/pxac130","type":"journal-article","created":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T18:25:20Z","timestamp":1680632720000},"page":"291-298","source":"Crossref","is-referenced-by-count":6,"title":["Acetaminophen versus indomethacin for patent ductus arteriosus management in premature infants: systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1093","volume":"28","author":[{"given":"Eyad","family":"Bitar","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Neonatal-Perinatal Care, University of Alberta , Edmonton"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Hyderi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatal-Perinatal Care, University of Alberta , Edmonton"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra M","family":"Campbell","sequence":"additional","affiliation":[{"name":"John W Scott Health Sciences Library, University of Alberta , Edmonton"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7879-7724","authenticated-orcid":false,"given":"Manoj","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatal-Perinatal Care, University of Alberta , Edmonton"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,4]]},"reference":[{"issue":"1","key":"2023072408342435200_CIT0001","doi-asserted-by":"crossref","first-page":"e1382138","DOI":"10.1542\/peds.2008-2418","article-title":"Failure of ductus arteriosus closure is associated with increased mortality in preterm infants","volume":"123","author":"Noori","year":"2009","journal-title":"Pediatrics"},{"issue":"Suppl 1","key":"2023072408342435200_CIT0002","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.1038\/sj.jp.7211465","article-title":"Patent ductus arteriosus: Pathophysiology and management","volume":"26","author":"Hermes-DeSantis","year":"2006","journal-title":"J Perinatol"},{"issue":"3","key":"2023072408342435200_CIT0003","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.clp.2020.05.007","article-title":"Patent ductus arteriosus-time for a definitive 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indomethacin for treatment of hemodynamically significant PDAs in VLBW infants","volume":"41","author":"Davidson","year":"2021","journal-title":"J Perinatol"},{"issue":"4","key":"2023072408342435200_CIT0016","article-title":"Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants","author":"Ohlsson","year":"2018","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"3","key":"2023072408342435200_CIT0017","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1097\/00000658-199609000-00011","article-title":"Increased risk of necrotizing enterocolitis in premature infants with patent ductus arteriosus treated with indomethacin","volume":"224","author":"Grosfeld","year":"1996","journal-title":"Ann Surg"},{"issue":"7","key":"2023072408342435200_CIT0018","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1038\/sj.jp.7210795","article-title":"Neonatal necrotizing enterocolitis with intestinal perforation in extremely premature infants receiving early Indomethacin treatment for patent Ductus Arteriosus","volume":"22","author":"Fujii","year":"2002","journal-title":"J Perinatol"},{"issue":"6","key":"2023072408342435200_CIT0019","doi-asserted-by":"crossref","first-page":"e1618","DOI":"10.1542\/peds.2011-0359","article-title":"Ductal closure with Paracetamol: A surprising new approach to patent Ductus Arteriosus treatment","volume":"128","author":"Hammerman","year":"2011","journal-title":"Pediatrics"},{"issue":"5","key":"2023072408342435200_CIT0020","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1007\/s00467-003-1402-z","article-title":"Indomethacin and renal impairment in neonates","volume":"19","author":"Akima","year":"2004","journal-title":"Pediatr Nephrol"},{"issue":"3","key":"2023072408342435200_CIT0021","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.ihj.2020.05.012","article-title":"The efficacy and safety of oral Paracetamol versus oral ibuprofen for patent Ductus Arteriosus 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