Bali Medical Journal (Bali MedJ) 2024, Volume 13, Number 1: 101-105 P-ISSN.2089-1180, E-ISSN: 2302-2914
Melatonin, an adjuvant for neonatal sepsis: a systematic review and meta-analysis
Dwi Hidayah1,2*, Harsono Salimo1,2, Tunjung Wibowo3, Brian Wasita1,4, Vitri Widyaningsih1,5, Hartono Hartono1,6, Soetrisno Soetrisno1,7
1Doctoral Program, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia;2Department of Pediatric, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia;3Department of Pediatric, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; 4Department of Anatomical Pathology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia; 5Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia;6Department of Physiology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia;7Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
ABSTRAK
Introduction: Neonatal sepsis remains a serious health problem in some countries, especially in developing countries, like Indonesia. The standard treatment for sepsis is the administration of antibiotics. Melatonin, a hormone produced by the pineal gland, has beneficial effects in fighting free radicals, antioxidants, anti-inflammatory, and anti-apoptotic effects. However, in newborns, melatonin is minimally detectable. Adjuvant therapy is required for the deterrence and neonatal sepsis therapy. This study aims to systematically review and perform a meta-analysis of melatonin as an adjunctive therapy in treating neonatal sepsis with the addition of the most recent articles.
Methods: Databases of electronics used such as PubMed, Embase, and the Cochrane Central Controlled Trials Register were searched systematically in October 2022 for clinical trials reporting the efficacy of melatonin as adjunctive therapy for neonatal sepsis. We compared treatment responses between groups using serum C-reactive protein (CRP) levels as an endpoint biomarker. Data analysis was performed to appraise the quality of enrolled studies using a comprehensive metaanalysis Revman 5.4 and bias tool risk of the Cochrane Collaboration.
Results: Four trials with a total of 175 subjects were listed in the systematic review and meta-analysis. Pooled analysis showed a statistically significant mean difference in serum CRP level (mg/L) between groups 24 hours after adjuvant melatonin therapy (-1.63 mg/L; 95% CI: -3.20 to -0.054; P=0.043).
Conclusion: Melatonin as an adjunctive therapy significantly lowers CRP levels. Larger, sample size studies are necessary to establish clear clinical benefits of this treatment.
Keywords: melatonin, meta-analysis, neonatal sepsis, systematic review. Cite This Article: Hidayah, D., Salimo, H., Wibowo, T., Wasita, B., Widyaningsih, V., Hartono, H., Soetrisno, S. 2024. Melatonin, an adjuvant for neonatal sepsis: a systematic review and meta-analysis. Bali Medical Journal 13(1): 101-105. DOI: 10.15562/ bmj.v13i1.4681