Key result
Combination therapy with acetaminophen and NSAIDs appears feasible and safe, but current evidence is insufficient to recommend it over monotherapy for routine PDA closure in preterm infants.
Why the study?
PDA management in preterm infants remains controversial with variable success from standard agents, and few studies have explored the effectiveness and safety of combination therapy.
Does combination pharmacological therapy (acetaminophen and NSAIDs) improve patent ductus arteriosus closure rates in preterm infants compared to monotherapy?
Does combination pharmacological therapy (acetaminophen and NSAIDs) improve patent ductus arteriosus closure rates in preterm infants compared to monotherapy?
Current evidence is insufficient to recommend routine combination therapy of acetaminophen and NSAIDs for PDA closure in preterm infants, highlighting the need for large-scale randomized controlled trials.
PDA management in preterm infants lacks consensus; leaves open the role of combination therapy in closure.
Management of patent ductus arteriosus (PDA) in preterm infants remains controversial and is a matter of continuous debate with a lack of consensus among practitioners on the optimal therapeutic strategy. The success rate of the most commonly used agents for PDA closure is variable, despite different medications, dosage regimens, routes of administration, and timing or duration of treatment. Combination therapy works by inhibiting prostaglandin production at different levels on the synthesis pathway; so combining acetaminophen and nonsteroidal anti-inflammatory drugs might potentially enhance PDA closure. Few studies explored the effectiveness and safety profile of combination therapy. This review summarizes the best available evidence on the efficacy and safety profile of combination pharmacological therapy for PDA treatment in preterm infants.
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Bitar et al. (2025) conducted a review in Patent ductus arteriosus (PDA). Combination therapy (acetaminophen and nonsteroidal anti-inflammatory drugs) vs. Monotherapy (acetaminophen or NSAID alone) was evaluated on PDA closure rate. Combination therapy with acetaminophen and NSAIDs appears feasible and safe, but current evidence is insufficient to recommend it over monotherapy for routine PDA closure in preterm infants.
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