Table 1.
Summary of the studies comparing oral ibuprofen and others (IV ibuprofen/indomethacin, oral paracetamol)
| Ref. | Comparison (n) | Gestational age (wk) | Method | Ductal closure rates | Comparison of adverse effects | Conclusion | |
| Aly et al[30] (LOE 1A) | IV INDO (9) Oral IBU (12) | IV INDO: 32.9 ± 1.6 Oral IBU: 31.2 ± 2.5 | Prospective, randomized, single mask | Oral IBU 83% | IV INDO 78% | Oral IBU = IV INDO | Oral IBU could be an easy to administer and efficacious alternative treatment. |
| Cherif et al[31] (LOE 1A) | IV IBU (32) Oral IBU (32) | IV IBU: 28.3 ± 1.1 Oral IBU: 29.3 ± 1.2 | Prospective, randomized, single mask | Oral IBU 70.30% | IV IBU 70% | Oral IBU < IV IBU | Early ductal closure with oral IBU is as good as IV route |
| Gokmen et al[10] (LOE 1A) | IV IBU (50) Oral IBU (52) | IV IBU: 28.7 ± 2.1 Oral IBU: 28.5 ± 1.9 | Prospective, randomized | Oral IBU 84.6%1 | IV IBU 62% | IV IBU = Oral IBU | Oral IBU is more effective than IV IBU for ductal closure in VLBW infants |
| Erdeve et al[11] (LOE 1A) | IV IBU (34) Oral IBU (36) | IV IBU: 26.3 ± 1.3 Oral IBU: 26.4 ± 1.1 | Prospective, randomized | Oral IBU 83.3%1 | IV IBU 61.70% | BPD is lower with oral IBU | Oral IBU is as effective as IV IBU for PDA closure even in < 1000 g preterm infants. |
| Keady et al[42] (LOE 1B) | Oral PARA (80) Oral IBU (80) | Oral PARA: 31.2 ± 1.8 Oral IBU: 30.9 ± 2.2 | Prospective, randomized | Oral PARA 81.20% | Oral IBU 78.80% | Oral PARA < Oral IBU | Oral PARA was comparable to IBU in terms of the rate of ductal closure and even showed a decreased risk of hyperbilirubinemia or gastrointestinal bleeding. |
| Oncel et al[21] (LOE 1B) | Oral PARA (40) Oral IBU (40) | Oral PARA: 27.3 ± 1.7 Oral IBU: 27.3 ± 2.1 | Prospective, randomized | Oral PARA 72.50% | Oral IBU 77.50% | Oral PARA = Oral IBU | Oral PARA is as effective as oral IBU for PDA closure. |
1
Differences were statistically significant (P < 0.05). LOE: Levels of evidence; IBU: Ibuprofen; INDO: Indomethacin; IV: Intravenous; PARA: Paracetamol; PDA: Patent ductus arteriosus; BPD: Bronchopulmonary dysplasia; VLBW: Very low birth weight.