NDLI: Comparison of two neonatal indomethacin protocols: efficacy and outcome for patent ductus arteriosus closure.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Rosito, G. Sum, K. Chorne, N.
Description	Country affiliation: United States Author Affiliation: Rosito G ( California Pacific Medical Center Department of Pharmacy, San Francisco, CA 94120, USA. rositog@sutterhealth.org)
Abstract	WHAT IS KNOWN: Indomethacin, a non-selective inhibitor of prostaglandin synthesis, is the gold standard treatment for patent ductus arteriosus (PDA). Indomethacin has been shown to permanently close the ductus and when given prophylactically, it reduces the incidence of PDA (1, 2). OBJECTIVE: This study compares PDA closure and surgical ligation rates between patients using two different indomethacin administration protocols. METHODS: This is a retrospective comparison analysis of 72 neonates, who received one of two indomethacin administration protocols. Our previous protocol suggested an initial dose of 0·2 mg/kg followed by two 0·1 mg/kg, with doses infused over 4 h and a 24-h dosing interval. A new potentially more useful protocol using the same mg/kg dose regimen but with doses infused over 30 min and a 12-h dosing interval, was evaluated. Each neonate was allowed three courses of treatment before surgical ligation was performed for persistent PDA. RESULTS: There were no statistically significant differences between the two protocol groups when comparing percentages of neonates with gestational age≤28 weeks, birth weight≤1000 g, male gender or receiving indomethacin for the indication of PDA prophylaxis vs. treatment. There was a trend towards a higher PDA closure rate and subsequently a lower PDA ligation rate in the new protocol when compared with the previous protocol. WHAT IS NEW AND CONCLUSION: In this small population of premature neonates, there was a trend, but no significant difference, towards increasing PDA closure and lower surgical ligation rates in neonates given indomethacin with more frequent dosing and shorter infusion time. A well-powered randomized controlled trial is now needed.
File Format	HTM / HTML
ISSN	02694727
Issue Number	5
Volume Number	35
e-ISSN	13652710
Journal	Journal of Clinical Pharmacy and Therapeutics
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2010-10-01
Publisher Place	Great Britain (UK)
Access Restriction	Subscribed
Subject Keyword	Discipline Therapeutics Discipline Pharmacology Anti-inflammatory Agents, Non-steroidal Administration & Dosage Therapeutic Use Ductus Arteriosus, Patent Drug Therapy Indomethacin Birth Weight Surgery Female Gestational Age Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases Male Retrospective Studies Treatment Outcome Comparative Study Journal Article
Content Type	Text
Resource Type	Article
Subject	Pharmacology Pharmacology (medical)

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