Should a prolonged or short course of indomethacin be used in preterm infants to treat patent ductus arteriosus

Report By: Sachin Shah - Fellow
Institution: Hospital for Sick Children and University of Toronto
Date Submitted: 30th January 2003
Date Completed: 13th July 2004
Last Modified: 13th July 2004
Status: Green (complete)

Three Part Question

In [preterm infants with patent ductus arteriosus] is [prolonged course indomethacin better than short course conventional therapy] in [preventing recurrences and decreasing the need for surgical ligation]

Clinical Scenario

A 27 week gestation infant is dignosed to have a significant patent ductus arteriosus (PDA) on Echocardiography on day 2. The infant is ventilator dependent. You decide to treat with indomethacin. The resident suggests that it would be better if we could administer prolonged indomethacin therapy over 5-7 days to ensure that the PDA remains closed. What evidence did she have?

Search Strategy

MEDLINE (1966-Dec 2002). Other databses searched were Cochrane Controlled Trials Register (Issue 4, 2002), EMBASE (1980-Dec 2002), CINAHL (1982-Dec 2002), abstracts published in Pediatric Research (1990-2002).