A Survey of Current Prophylactic Treatment for Ophthalmia Neonatorum in Croatia and a Review of International Preventive Practices

Abstract

BackgroundOphthalmia neonatorum, or neonatal conjunctivitis, is an acute infection that occurs within the first 28 days of life. This aim of this survey was to evaluate the current methods of preventive treatment for ophthalmia neonatorum in maternity hospitals in Croatia.Material/MethodsThe annual hospital birth rate in Croatia is approximately 40,000. A clinical survey was undertaken with data collected using questionnaires sent to all 32 maternity hospitals in Croatia. There was a 100% response rate to the questionnaires.ResultsPreventive treatment for ophthalmia neonatorum was administrated to all newborns in 75% (24/32) of Croatian maternity hospitals. In 45.8% of maternity hospitals, (11/32) these procedures were performed within the first hour after birth. In 54.2% of maternity hospitals (13/32), preventive treatment for ophthalmia neonatorum was administrated to all newborns from one to three hours after birth. The main treatment agent was tobramycin (83.3%). Other topical prophylactic treatments included povidone-iodine (8.3%), erythromycin (4.2%), and silver nitrate (4.2%). In 25% of obstetric units, prophylaxis for ophthalmia neonatorum was not used routinely, but in cases of diagnosed neonatal conjunctivitis, antibiotic treatment with tobramycin was mainly used.ConclusionsA survey of all 32 maternity hospitals in Croatia showed variation in the prevalence of preventive treatment for ophthalmia neonatorum and the methods used. These findings support the need to implement standardized preventive measures that both conform to international clinical guidelines and recognize treatment availability in Croatia, where topical povidone-iodine is currently preferred for the prevention of ophthalmia neonatorum.

Bactericidal Effect of 5-Mercapto-2-nitrobenzoic Acid-Coated Silver Nanoclusters against Multidrug-Resistant Neisseria gonorrhoeae

“…47 Although the use of AgNO 3 is generally no longer recommended, there are occasional reports of its use for treating neonatal conjunctivitis. 48 Figure 2 shows the percentage of N. gonorrhoeae (strain P9-17) killed by MNBA-AgNCs, AgNO 3 , and ceftriaxone, at increasing concentrations and different incubation times. MNBA-AgNCs, AgNO 3 , and ceftriaxone treatments showed doseand time-dependent bactericidal effects.…”

Antimicrobial use in an Indonesian community cohort 0-18 months of age

“…For example, preventive treatment for ON was not routinely used in Britain, Denmark, Sweden and Norway, while in the USA, Israel, Mexico, and Austria, prophylactic treatments for ON were recommended [36–40]. In countries where ON topical preventive treatment of newborn was routinely applied, a variety of topical agents were used, such as 1% silver nitrate, 1% tetracycline, macrolides (0.5% erythromycin or azithromycin), aminoglycosides (gentamicin and tobramycin), chloramphenicol or povidone-iodine [37]. In Indonesia, 1% chloramphenicol ointment was commonly used as preventive agent against ON [41].…”

Challenges in treating ophthalmia neonatorum

“…Ophthalmia neonatorum remains a global issue, threatening the sight of children worldwide [31][32]. The prevalence of ophthalmia neonatorum varies for different regions of the world and due to underreporting, decades of relatively low rates of ophthalmia neonatorum associated blindness in developed regions, and lack of resources for either diagnostics or treatment in low resource areas, there are few recent figures available and those that are available are specific to a particular etiological agent [5][6][8][9][18][19][20][21][22][23][24].…”

“…These cases led to a call to reintroduce ocular prophylaxis [12]. Prophylaxis to prevent ophthalmia neonatorum continues in countries including Spain [121], Brazil [122], the United States of America [57], Slovenia [123], Croatia [9], Canada [18], France [124], and Tanzania [125] (Table 2). However, prophylaxis has been discontinued in other countries, where the incidence of STIs is believed to be lower and where ophthalmia neonatorum risk is believed to therefore be lower, such as in Australia [126], United Kingdom [72], The Netherlands [109], Sweden [30], Denmark [30], and Belgium [127] (Table 2).…”

“…Clinical manifestations of ophthalmia neonatorum include purulent discharge and redness and swelling of the eyelid and conjunctiva [7][8][9]. In severe cases, the cornea may become affected, resulting in inflammation, thinning, ulceration, perforation, and ultimately blindness [10].…”