Treatment and prevention of ophthalmia neonatorum.
OBJECTIVE
In my office I occasionally see neonates with conjunctivitis. What are the current recommendations for ocular prophylaxis at birth? Do topical antibiotics alone provide adequate treatment of neonatal conjunctivitis? When is systemic therapy indicated?


CONCLUSIONS
All infants should receive ocular prophylaxis at birth to prevent gonococcal ophthalmia. Neonates presenting with signs of conjunctivitis should have a conjunctival swab sent for Gram stain and culture. If Gram-negative diplococci are present on the Gram stain results, the infants and their parents should be treated immediately for presumed gonorrhea. Infants with chlamydial infection should be treated with oral antibiotics. Most of all other forms of bacterial conjunctivitis can be treated with topical antibiotics, with the exception of Pseudomonas infection. Infants should be followed during their treatment and upon completion of therapy to ensure resolution of symptoms. For cases in which sexually transmitted bacteria are implicated, the mothers and their sexual partners should be treated.
BC Children's Hospital, Department of Pediatrics, Room K4-226, Ambulatory Care Bldg, 4480 Oak St, Vancouver, BC V6H 3V4. rgoldman@cw.bc.ca.
Adela
A
Matejcek
Ran D
RD
Goldman
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002690:Chlamydia Infections / Q000188:drug therapy / Q000517:prevention & control; D003231:Conjunctivitis / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control*; D004917:Erythromycin / Q000627:therapeutic use*; D006561:Herpes Simplex / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D009878:Ophthalmia Neonatorum / Q000188:drug therapy / Q000517:prevention & control*; D012835:Silver Nitrate / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000517:prevention & control; D013211:Staphylococcus aureus; D013752:Tetracycline / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D004917:Erythromycin; D012835:Silver Nitrate; D013752:Tetracycline