EFFECTS OF MELATONIN AS ADJUVANT THERAPY IN TREATMENT OF NEONATAL SEPSIS

Background: Neonatal sepsis is a critical concern, causing significant morbidity and mortality, especially in preterm and low-birth-weight infants. Traditional treatments, including antibiotics and supportive care, often fall short in reducing high mortality rates, emphasizing the need for effective adjunct therapies. Melatonin, known for its antioxidant and anti-inflammatory properties, may offer therapeutic benefits by modulating immune responses and mitigating oxidative stress in neonatal conditions. Objective: This study evaluates the effectiveness of melatonin as an adjunct therapy in neonatal sepsis, focusing on improvements in clinical and laboratory outcomes. Methods: In this randomized controlled trial conducted at the Department of Neonatology at Children Hospital, PIMS, Islamabad from September 1, 2023, to February 28, 2024, 60 neonates diagnosed with sepsis were divided into two groups. The experimental group (Group A) received 20 mg of enteral melatonin in addition to standard care, while the control group (Group B) received standard care alone. Key metrics such as sepsis scores, C-reactive protein (CRP) levels, and complete blood counts were assessed at baseline and 48 hours post-treatment. Results: Significant improvements were observed in the melatonin group, with sepsis scores decreasing from an average of 12.2 ± 3.1 to 6.1 ± 1.8, CRP levels reducing from 12.5 mg/ml to 6.5 mg/ml, and total leukocyte counts dropping from 12,500 cells/µL to 9,800 cells/µL. The control group showed lesser improvements across these parameters. Conclusion: Melatonin shows potential as an adjunct treatment in neonatal sepsis, effectively reducing inflammation and enhancing clinical outcomes. Further research is needed to substantiate these findings and integrate melatonin into broader clinical practices.