Gonococcal ophthalmia neonatorum

For prophylaxis of ophthalmia neonatorum, various groups have proposed the use of erythromycin (0.5%) or tetracycline (1%) ophthalmic ointment in lieu of silver nitrate. Although silver nitrate and antibiotic ointments are effective against gonococcal ophthalmia neonatorum, silver nitrate is not effective for chlamydial disease and may cause a chemical conjunctivitis. 

A fixed-combination ointment containing oxytetracy-cline and polymyxin B is available for topical ocular use (see Table 11-6). The Centers for Disease Control and Prevention recommends ophthalmic ointments containing a tetracycline or erythromycin as an effective alternative to silver nitrate for prophylaxis of gonococcal ophthalmia neonatorum. A major advantage of using an antibiotic ointment such as oxytetracycline-polymyxin B is that it does not canse the chemical conjunctivitis typically produced by silver nitrate. 

Though silver nitrate causes chemical conjunctivitis in about 90% of the infants in the first 24 hours of life, obvious conjunctivitis is rare after this period. The chemical conjunctivitis does not increase the risk of secondary infection, nor does it mask bacterial infection. Rinsing will not prevent the development of conjunctivitis. Discontinuation of the prophylactic use of silver nitrate appears to result in a significant rise of gonococcal ophthalmia neonatorum in high-risk populations. 

Ceftriaxone 25 to 50 mg/kg intravenously or intramuscularly as a single dose for ophthalmia neonatorum or infants born to mothers with gonococcal infection as prophylaxis... 

Gonococcal conjunctivilis in adults Ophthalmia neonatorum Infants bom to mothers with gonococcal infection (prophylaxis)... 

Neisseria gonorrhoeae Ophthalmia Neonatorum. Gonococcal neonatal conjunctivitis is characterized by the neonate s development of hyperacute conjunctivitis between 2 and 5 days postpartum. Most cases of neonatal gonococcal conjunctivitis are bilateral periorbital edema, chemosis, and purulent exudate are prominent (Figure 25-18). 

Ophthalmia neonatorum—Inflammation of the conjunctiva resulting from acquisition of gonococcal infection at birth. 

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