{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T15:37:21Z","timestamp":1770910641687,"version":"3.50.1"},"reference-count":26,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objective: Patent Ductus Arteriosus (PDA) is a common congenital heart defect causing high morbidity and mortality in preterm neonates. IV ibuprofen is the standard treatment, with acetaminophen as a potential alternative when ibuprofen is contraindicated. However, evidence for acetaminophen\u2019s effectiveness is inconclusive. This study aimed to compare the efficacy and safety of IV acetaminophen versus IV ibuprofen as the initial treatment for PDA closure in preterm neonates. Methods: A retrospective cohort study was conducted at a tertiary Saudi hospital. This study included preterm neonates with a gestational age of \u226432 weeks diagnosed with PDA and treated with IV ibuprofen or IV acetaminophen. The primary outcome was to evaluate the efficacy of ibuprofen versus acetaminophen for treating PDA. Results: A total of 95 courses were included. Of these, 49 neonates received ibuprofen, and 18 neonates received acetaminophen as first therapy. The mean age at the initial course was 5.47 \u00b1 10.30 days for the ibuprofen group and 5.22 \u00b1 6.43 days for the acetaminophen group. In most neonates, the hemodynamic significance of the PDA was confirmed by ultrasound examination. As a result, 35 of 49 neonates treated with ibuprofen experienced successful full PDA closure, with a rate of 71.4%, compared to 10 of 18 in the acetaminophen group, which had a rate of 55.6%. However, this difference was not statistically significant (p-value = 0.35). Conclusions: A trend toward higher PDA closure with ibuprofen was observed compared to acetaminophen, without a statistically significant difference. Both treatments showed comparable safety. Further studies are needed to confirm these findings and optimize acetaminophen dosing.<\/jats:p>","DOI":"10.3390\/children13020257","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T14:06:16Z","timestamp":1770905176000},"page":"257","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Effectiveness of Ibuprofen Versus Acetaminophen in Closing Patent Ductus Arteriosus in Preterm Neonates"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8972-9791","authenticated-orcid":false,"given":"Shaimaa","family":"Alsulami","sequence":"first","affiliation":[{"name":"Pharmaceutical Practices Department, Faculty of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Aljehani","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Care Services, King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center (KAIMRC), Jeddah 21423, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Najla","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"Population Health Management, Jeddah Second Health Cluster, Ministry of Health, Jeddah 23816, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5261-9196","authenticated-orcid":false,"given":"Mohammed Y.","family":"Al-Hindi","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center (KAIMRC), Jeddah 21423, Saudi Arabia"},{"name":"Neonatal Intensive Care Department, King Abdullah Specialized Children\u2019s Hospital, Jeddah 22384, Saudi Arabia"},{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Care Services, King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center (KAIMRC), Jeddah 21423, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s00431-016-2830-7","article-title":"Comparative study of the efficacy and safety of paracetamol, ibuprofen, and indomethacin in closure of patent ductus arteriosus in preterm neonates","volume":"176","author":"Elgendy","year":"2017","journal-title":"Eur. J. Pediatr."},{"key":"ref_2","first-page":"138","article-title":"Patent ductus arteriosus: An overview","volume":"12","author":"Dice","year":"2007","journal-title":"J. Pediatr. Pharmacol. Ther. JPPT Off. J. PPAG"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e20201209","DOI":"10.1542\/peds.2020-1209","article-title":"Patent ductus arteriosus of the preterm infant","volume":"146","author":"Hamrick","year":"2020","journal-title":"Pediatrics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"907","DOI":"10.2165\/11632870-000000000-00000","article-title":"Patent ductus arteriosus in premature neonates","volume":"72","author":"Agarwal","year":"2012","journal-title":"Drugs"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1001\/jamapediatrics.2015.0987","article-title":"Diagnosis, Evaluation, and Management of Patent Ductus Arteriosus in Preterm Neonates","volume":"169","author":"Jain","year":"2015","journal-title":"JAMA Pediatr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s40272-016-0165-5","article-title":"Pharmacological Closure of Patent Ductus Arteriosus: Selecting the Agent and Route of Administration","volume":"18","author":"Sivanandan","year":"2016","journal-title":"Paediatr. Drugs"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e025784","DOI":"10.1161\/JAHA.122.025784","article-title":"Patent Ductus Arteriosus: A Contemporary Perspective for the Pediatric and Adult Cardiac Care Provider","volume":"11","author":"Backes","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1007\/s00431-020-03780-8","article-title":"Intravenous paracetamol in comparison with ibuprofen for the treatment of patent ductus arteriosus in preterm infants: A randomized controlled trial","volume":"180","author":"Dani","year":"2021","journal-title":"Eur. J. Pediatr."},{"key":"ref_9","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"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jpeds.2016.04.066","article-title":"Paracetamol Accelerates Closure of the Ductus Arteriosus after Premature Birth: A Randomized Trial","volume":"177","author":"Aikio","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"130","DOI":"10.4103\/apc.APC_115_19","article-title":"Comparison of the efficacy and safety of indomethacin, ibuprofen, and paracetamol in the closure of patent ductus arteriosus in preterm neonates\u2014A randomized controlled trial","volume":"13","author":"Meena","year":"2020","journal-title":"Ann. Pediatr. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Robles, A., Gimeno Navarro, A., Serrano Mart\u00edn, M.d.M., P\u00e1rraga Quiles, M.J., Parra Llorca, A., Poveda-Andr\u00e9s, J.L., Vento Torres, M., and Aguar Carrascosa, M. (2020). Paracetamol vs. Ibuprofen in Preterm Infants with Hemodynamically Significant Patent Ductus Arteriosus: A Non-inferiority Randomized Clinical Trial Protocol. Front. Pediatr., 8.","DOI":"10.3389\/fped.2020.00372"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1159\/000345337","article-title":"Intravenous paracetamol treatment in the management of patent ductus arteriosus in extremely low birth weight infants","volume":"103","author":"Oncel","year":"2013","journal-title":"Neonatology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.jpeds.2013.11.008","article-title":"Oral paracetamol versus oral ibuprofen in the management of patent ductus arteriosus in preterm infants: A randomized controlled trial","volume":"164","author":"Oncel","year":"2014","journal-title":"J. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.1080\/14767058.2017.1338263","article-title":"Paracetamol versus ibuprofen for the treatment of patent ductus arteriosus in preterm neonates: A meta-analysis of randomized controlled trials","volume":"31","author":"Huang","year":"2018","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e20240058","DOI":"10.36660\/abc.20240058","article-title":"Efic\u00e1cia e Seguran\u00e7a Terap\u00eautica do Paracetamol versus Ibuprofeno na Persist\u00eancia do Ducto Arterial em Rec\u00e9m-Nascidos: Uma Revis\u00e3o Sistem\u00e1tica","volume":"121","author":"Franco","year":"2024","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1007\/s00431-015-2541-5","article-title":"Limited effects of intravenous paracetamol on patent ductus arteriosus in very low birth weight infants with contraindications for ibuprofen or after ibuprofen failure","volume":"174","author":"Roofthooft","year":"2015","journal-title":"Eur. J. Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"F127","DOI":"10.1136\/archdischild-2014-307312","article-title":"Paracetamol for the treatment of patent ductus arteriosus in preterm neonates: A systematic review and meta-analysis","volume":"101","author":"Terrin","year":"2016","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_19","first-page":"507","article-title":"Late Acetaminophen Therapy for Patent Ductus Arteriosus in the Preterm Neonate","volume":"25","author":"King","year":"2020","journal-title":"J. Pediatr. Pharmacol. Ther. JPPT Off. J. PPAG"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"F253","DOI":"10.1136\/archdischild-2014-307930","article-title":"Late medical therapy of patent ductus arteriosus using intravenous paracetamol","volume":"100","author":"James","year":"2015","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_21","first-page":"38","article-title":"Acetaminophen vs. ibuprofen in early treatment of patent ductus arteriosus in preterm infants: A non-inferiority randomized clinical trial","volume":"1","author":"Potsiurko","year":"2022","journal-title":"SVOA Paediatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1186\/s13063-016-1294-4","article-title":"Efficacy and safety of intravenous paracetamol in comparison to ibuprofen for the treatment of patent ductus arteriosus in preterm infants: Study protocol for a randomized control trial","volume":"17","author":"Dani","year":"2016","journal-title":"Trials"},{"key":"ref_23","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 closure in preterm neonates\u2014A systematic review and meta-analysis","volume":"72","author":"Pranata","year":"2020","journal-title":"Indian Heart J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1542\/peds.2005-1528","article-title":"Prevalence of spontaneous closure of the ductus arteriosus in neonates at a birth weight of 1000 grams or less","volume":"117","author":"Koch","year":"2006","journal-title":"Pediatrics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1055\/s-0028-1090594","article-title":"The ductus arteriosus rarely requires treatment in infants > 1000 grams","volume":"25","author":"Nemerofsky","year":"2008","journal-title":"Am. J. Perinatol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Mukherjee, A., Gupta, A., Fullwood, C., and Gottstein, R. (2026). Paracetamol or ibuprofen? A pilot study comparing rescue therapy for PDA in preterm infants within the first month. Front. Pediatr., 13.","DOI":"10.3389\/fped.2025.1717284"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/2\/257\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T14:48:55Z","timestamp":1770907735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/2\/257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":26,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["children13020257"],"URL":"https:\/\/doi.org\/10.3390\/children13020257","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]}}}