Role of Melatonin in Treatment of Necrotizing Enterocolitis in Preterm Neonates

Abstract
Background: Necrotizing enterocolitis (NEC) is one of the most dangerous gastrointestinal diseases that affects the neonates especially preterm neonates. It can lead to severe morbidity and even mortality, so early detection of NEC would give us good chance for early prevention and treatment with better prognosis. Free radicals play a significant role in the pathogenesis of neonatal sepsis and NEC. It has been suggested that melatoninas an antioxidant can be used to counteract the toxicity of oxygen radicals that are released during neonatal illness.
Aim of Study: Is to Determine the role of melatonin as an adjuvant therapy in treating necrotizing enterocolitis (NEC) in preterm neonates.
Patients and Methods: A prospective clinical trial study was conducted on 20 preterm neonates which suffer from NEC diagnosed on the basis of both clinical and laboratory criteria. group (G I) (n=10) received melatonin and antibiotics, while the control group (G II) (n=10) was treated with antibi-otics only. Melatonin was administered as 20 mg for 3 con-secutive days and antibiotics were administered according to a standard protocol protocol and followed-up of symptoms and signs of NEC after 5,10 and 15 days of starting treatment.
Results: As regard outcome of NEC, In group I there were 9 (90%) cases improved and 1 (10%) case not improved but In group II there were 5 (50%) cases improved and 5 (50%) cases not improved, so more cases in group I who received melatonin showed improvement of NEC than group II. As regard mortality, one baby (10%) died and 9 (90%) survived in group I compared to 3 babies (30%) died and 7 babies (70%) survived in group II.As regard length of NICU stay the patients who received melatonin (group I) stay for a shorter period in NICU compared to group II who received traditional therapy only.
Conclusion: Melatonin administration as an adjuvant therapy in NEC treatment in preterm neonates is associated with improvement of clinical and laboratory outcome.