Neonatal conjunctivitis
exp date isn't null, but text field is
Neonatal conjunctivitis or ophthalmia neonatorum is an acute purulent conjunctivitis during the first month of life. It is usually contracted from infected genital secretions of the mother.
Cleaning of the neonate’s eyes immediately after birth and the application of 1% tetracycline ointment into the eyes, is effective in preventing the condition. This must be implemented as a policy in all health facilities in which child deliveries are undertaken.
Cause
- Neisseria gonorrhoea
- Chlamydia trachomatis
- Staphylococci
- Streptococci
- Herpes Simple virus
- Chemical e.g. silver nitrate
Symptoms
- Eye discharge
- Swelling of the eye lids
Signs
- Eye discharge, which may be purulent
- Redness and swelling of the conjunctivae
- Oedema and redness of the eyelids
Investigations
- Conjunctival swabs for Gram staining and culture
TreatmentTreatment Objectives
- To treat the infection
- To prevent blindness
Non-pharmacological treatment
Clean the eyelids frequently (every 2 hours) with cotton wool dipped in sterile saline solution. In the absence of sterile saline solution, use boiled water that has been left to cool.
Pharmacological treatment Treatment of baby
Evidence Rating: [B]
- Ceftriazone, IM or IV, 50 mg/kg stat. (max.125 mg)
Or
- Cefotaxime, IM, 100 mg/kg stat.
And
- Erythromycin, oral, 12.5 mg/kg 6 hourly for 14 days
And
- Chloramphenicol eye drops, 0.5% applied to each eye every 2 hours for 48 hours (after cleaning away discharge-saline irrigation)
Then
- Chloramphenicol eye drops, 0.5% applied to each eye 6 hourly
And
- Chloramphenicol eye ointment, 1% applied to each eye at night
Treatment of mother
Evidence Rating: [A]
- Ceftriaxone, IM, 250 mg stat.
And
- Erythromycin, oral, 500 mg 6 hourly for 7 days
Treatment of mother’s partner(s) for gonorrhoea and chlamydia
- Ceftriaxone, IM, 250 mg stat.
Or
- Cefixime, oral, 400 mg stat.
Or
- Ciprofloxacin, oral, 500 mg stat.
And
- Doxycycline, oral, 100 mg 12 hourly for 7 days
Or
- Tetracycline, oral, 500 mg 6 hourly for 7 days
Or
- Erythromycin, oral, 500 mg 6 hourly for 7 days
Or
- Azithromycin, oral, 1 g stat.
Referral Criteria
- Refer all neonates with corneal involvement and or severe neonatal conjuctivitis not responding to treatment to a paediatrician and or an ophthalmologist.