Prophylaxis of ophthalmia neonatorum--a nationwide survey of the current practice in Austria.
The aim of this study was to analyze the current practice of Ophthalmia neonatorum prophylaxis in Austria. Questionnaires were sent to 107 hospitals with obstetric units, as well as to 490 registered community midwives, together looking after a yearly total of approximately 70,000 births. The overall return of the hospitals and midwives was 91.6% and 7.6%, respectively.


RESULTS
Ophthalmia neonatorum prophylaxis is being applied by 93.8% of all respondents (hospitals 96.9%, and community midwives 82.3%). The three most frequently applied substances were Erythromycin (41.8%), Gentamicin (21.3%) and Silver nitrate (19.7%). Other substances were Tetracycline, Povidone-Iodine, Neomycin and Chloramphenicol. The reported overall-observation of chemical conjunctivitis after application of a prophylactic agent was 42.3% (55/133), typically after the use of Silver nitrate, Erythromycin or Tetracycline. The agent was determined by pediatricians (29%), in accordance to governmental decree (15%), by hospital policy (12%), effectiveness against Chlamydia and Gonococci (9%), by pharmacists (3%) and ophthalmologists (3%). 18% did not give any reason for the choice of agent.


CONCLUSIONS
The rationale for prophylaxis and the substances used in Austria show heterogeneity. Seven prophylactic agents are used, two antiseptics and five antibiotics. 25% of the routine applicants are using substances (Gentamicin, Neomycin or Chloramphenicol) for which no evidence based efficacy for prophylaxis of Ophthalmia neonatorum has been demonstrated through clinical trials. However, 83.5% of the maternity units do not want changes in their current routine, unless there is a nation-wide agreement for Ophthalmia neonatorum prophylaxis.
Assadian
Ojan
O
Division of Hospital Hygiene, Institute of Hygiene, University of Vienna Medical School, Vienna, Austria. ojan.assadian@akh-wien.ac.at
Assadian
Afshin
A
Aspöck
Christoph
C
Hahn
Daniela
D
Koller
Walter
W
D000891:Anti-Infective Agents, Local / Q000008:administration & dosage* / Q000009:adverse effects; D001317:Austria / Q000453:epidemiology; D003231:Conjunctivitis / Q000139:chemically induced / Q000453:epidemiology; D019091:Critical Pathways; D004917:Erythromycin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000009:adverse effects; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009878:Ophthalmia Neonatorum / Q000209:etiology / Q000517:prevention & control*; D009883:Ophthalmic Solutions; D011247:Pregnancy; D012835:Silver Nitrate / Q000008:administration & dosage / Q000009:adverse effects
D000891:Anti-Infective Agents, Local; D005839:Gentamicins; D009883:Ophthalmic Solutions; D004917:Erythromycin; D012835:Silver Nitrate