A pilot randomised blinded placebo-controlled trial of paracetamol for later treatment of a patent ductus arteriosus

Objectiveto explore the efficacy and risks of oral paracetamol in later (>2 weeks old) treatment of patent ductus arteriosus (pda).study design a multicentre double-blind placebo-controlled randomised pilot trial in three neonatal intensive care units in australia. infants born <33 weeks with haemodynamically significant pda were treated with a 5-day course of oral paracetamol or placebo. cardiac ultrasounds were used to document haemodynamic parameters. the primary outcome analysed was ductal closure by 48 h after treatment completion. secondary outcomes included reduction in ductal diameter >25% and safety.resultsfifty-five infants were enrolled, of whom 27 received paracetamol and 28 placebo. eighty percent had received previous non-steroidal anti-inflammatory drug. mean postnatal age was 25 days. four of the 27 ducts treated with paracetamol closed vs. 0/28 treated with placebo (p = 0.05). an additional 13/27 given  paracetamol vs. 7/28 given placebo showed significant constriction (p = 0.008). no adverse effects were observed .conclusionsthere was some evidence of increased closure with oral paracetamol at postnatal age >2 weeks; however, the overall efficacy was not high.