title: Practice points - Neonatal Intensive Care Drug Manual
text: A large body of evidence demonstrates that early, routine treatment to induce closure of the ductus in preterm infants, either medically or surgically, in the first 2 weeks after birth does not improve long-term outcomes.
  The role of more selective use of medical methods for induction of ductal closure, either for defined high-risk infants in the first 2 postnatal weeks, or more generally, for older infants in whom the ductus remains patent, remains uncertain and requires further study. [30]
  Oral ibuprofen was associated a reduced failure rate to close the PDA, no difference in neonatal morbidities including intestinal perforation and gastrointestinal bleed, and lower creatinine levels after treatment compared to intravenous ibuprofen. [6] [LOE I]
  Although high dose ibuprofen (oral or intravenous) is associated with a reduced failure rate to close the PDA, there are insufficient data to assess its safety. [6]
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