Journal of Patient Safety & Quality Improvement

Journal of Patient Safety & Quality Improvement

The effect of melatonin on the immune system and the treatment of neonatal sepsis

Document Type : Original Article

Authors
reza saeidi 1
Parinaz Alizadeh 2
Mohammad Kazemian 2
Shamsollah noripour 2
minoo fallahi 2
1 Neonatal Health Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Neonatal Health Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
10.22038/psj.2025.91025.1490
Abstract
Introduction:
Neonatal sepsis is a leading cause of morbidity and mortality, particularly in preterm infants, involving systemic inflammation and oxidative stress. Melatonin, with its antioxidant, anti-inflammatory, and immunomodulatory properties, has emerged as a potential adjuvant to standard antibiotic therapy. This systematic review and meta-analysis synthesizes evidence from randomized controlled trials (RCTs) and clinical studies from 2000 to 2025 evaluating melatonin's efficacy and safety in neonatal sepsis.
Materials and Methods:
Databases including PubMed, Embase, Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov were searched for RCTs and trials on melatonin as adjuvant in neonatal sepsis. Inclusion: studies 2000-2025, neonates (<28 days), confirmed sepsis, melatonin vs. control (antibiotics alone). Outcomes: biomarkers (C-reactive protein or CRP, Malondialdehyde or MDA, Interlukine or IL-6/8), sepsis scores, mortality, hospital stay, adverse events.
Results:
Nine RCTs (n=354 neonates) included. Melatonin (typically 20 mg oral, single or divided) reduced CRP at 24h (P<0.001) and MDA (P<0.001). Improved sepsis recovery at 72h (P<0.001). Mortality lower (P<0.001), no adverse events. Preterm subgroup showed enhanced benefits.
Conclusions:
Melatonin improves biomarkers and outcomes in neonatal sepsis safely, but Larger RCTs needed for confirmation and dosing.
Keywords
Melatonin
neonatal sepsis
adjuvant therapy
Subjects
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Journal of Patient Safety & Quality Improvement
Volume 13, Issue 4
Autumn 2025
Pages 235-239