Melatonin replacement therapy in preterm infants: the impact of pharmacokinetics.

The paper by Merchant et al. demonstrates that the pharmacokinetic profile of melatonin differs in preterm infants from that of adults. The findings of this study can guide the necessary future preventive and therapeutic clinical trials on melatonin in preterm infants. These studies are urgently needed to further evaluate the protective potential of melatonin in preterm infants. Melatonin acts as a potent endogenous antioxidant agent that antagonizes oxidative stress, and melatonin replacement therapy could thereby prevent the development of many disorders and diseases that can afflict preterm infants such as sepsis, asphyxia, respiratory distress or surgical complications. Since preterm infants are melatonin deficient, administration of the compound may provide the necessary levels to assure their health and well-being. Pharmacokinetic data such as those provided in the evaluated paper are necessary to establish safe and efficient melatonin treatment regimens in this highly susceptible population.