Treatment of gonococcal conjunctivitis with a single intramuscular injection of cefotaxime.
Between 25% and 50% of children in African countries are exposed to Neisseria gonorrhoeae at birth and are at risk of developing gonococcal ophthalmia neonatorum. The problem is aggravated by the emergence of penicillinase-producing strains of N. gonorrhoeae (PPNG). Twenty-one children (9 boys, 12 girls, mean age 13 days) presenting with gonococcal conjunctivitis were identified during a 47-month period. Nineteen children received a single im injection of 100 mg/kg cefotaxime (maximum dose 1 g) without topical antibiotic therapy. One neonate with concurrent otitis media was treated with cefotaxime for five days and a 17-month old girl received two im injections because of the severity of her symptoms. Eight patients (38%) had received previous antibiotic therapy (penicillin im and/or tetracycline eye ointment). Twelve isolates of N. gonorrhoeae were found to be PPNG strains. At three to seven day follow-up examination all 21 patients were clinically cured without residual eye damage. Cefotaxime offers an effective first line treatment for gonococcal ophthalmia neonatorum in areas where there is a high prevalence of PPNG strains. The advantages of a single-dose treatment over multidose regimens in terms of compliance and cost are discussed.
Lepage
P
P
Department of Paediatrics, Centre Hospitalier de Kigali, Rwanda.
Kestelyn
P
P
Bogaerts
J
J
D002439:Cefotaxime / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007273:Injections, Intramuscular; D008297:Male; D009878:Ophthalmia Neonatorum / Q000188:drug therapy*
D002439:Cefotaxime