An Update on Neonatal and Pediatric Conjunctivitis

Andalibi, Sassan; Haidara, Moulaye; Bor, Nurit; Levin, Moran

doi:10.1007/s40135-015-0080-x

Cited by 5 publications

(3 citation statements)

References 76 publications

(78 reference statements)

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“…N. gonorrhoeae is a common cause of ophthalmia neonatorum or neonatal conjunctivitis acquired during delivery from an infected mother. If left untreated, it can lead to corneal perforation and blindness, with neonatal conjunctivitis being a major cause of childhood corneal blindness in developing countries [26][27][28] . With the increasing occurrence of multidrug-resistant strains of bacteria, an alternative treatment for N. gonorrhoeae is very valuable and these experiments show that Bald's eyesalve has the potential to be developed into a viable alternative.…”

Section: Discussionmentioning

confidence: 99%

The safety profile of Bald’s eyesalve for the treatment of bacterial infections

Anonye

Nweke

Furner-Pardoe

et al. 2020

Sci Rep

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The rise in antimicrobial resistance has prompted the development of alternatives to combat bacterial infections. Bald’s eyesalve, a remedy used in the Early Medieval period, has previously been shown to have efficacy against Staphylococcus aureus in in vitro and in vivo models of chronic wounds. However, the safety profile of Bald’s eyesalve has not yet been demonstrated, and this is vital before testing in humans. Here, we determined the safety potential of Bald’s eyesalve using in vitro, ex vivo, and in vivo models representative of skin or eye infections. We also confirmed that Bald’s eyesalve is active against an important eye pathogen, Neisseria gonorrhoeae. Low levels of cytotoxicity were observed in eyesalve-treated cell lines representative of skin and immune cells. Results from a bovine corneal opacity and permeability test demonstrated slight irritation to the cornea that resolved within 10 min. The slug mucosal irritation assay revealed that a low level of mucus was secreted by slugs indicating moderate mucosal irritation. We obtained promising results from mouse wound closure experiments; no visible signs of irritation or inflammation were observed. Our results suggest that Bald’s eyesalve could be tested further on human volunteers to assess safety for topical application against bacterial infections.

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Section: Discussionmentioning

confidence: 99%

The safety profile of Bald’s eyesalve for the treatment of bacterial infections

Anonye

Nweke

Furner-Pardoe

et al. 2020

Sci Rep

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“…Chemical conjunctivitis usually resolves within 2 days [10][11] and may not usually require treatment [11], while those of infectious origin often require treatment [12][13].…”

Section: Introductionmentioning

confidence: 99%

Challenges in treating ophthalmia neonatorum

Ukachukwu

Rafiq

Snyder

2020

Expert Review of Ophthalmology

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Introduction: Ophthalmia neonatorum is a severe, sight-threatening condition that occurs in neonates worldwide. Etiological factors include chemical agents, viruses, and bacteria, such as Neisseria gonorrhoeae and Chlamydia trachomatis acquired from infected mothers at birth. Prevalence varies geographically, depending upon socioeconomic conditions, maternal health care, and prophylactic treatments available. Antibiotic resistance, particularly in N. gonorrhoeae, is a major challenge in treating ophthalmia neonatorum.Areas covered: This review explores the epidemiology and diagnosis of ophthalmia neonatorum and analyses the history and practices of prophylaxis and treatment. In this context, the challenges in treating ophthalmia neonatorum today are discussed and innovations that may overcome these challenges in the future are presented. Advantages and challenges of strategies to prevent ophthalmia neonatorum involving prophylaxis of infants and those using screening and treatment of mothers are explored. Expert commentary:Despite the potential to rapidly cause blindness, there are no universal guidelines for the prevention and treatment of ophthalmia neonatorum. Due to the increasing number of treatment failures, particularly those of extensively drug-resistant N. gonorrhoeae, a pragmatic approach is needed. Enhanced availability of screening and treatment of pregnant mothers, coupled with development of new antimicrobial ocular prophylaxis and treatments, provide options for a variety of settings.

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“…The American Academy of Ophthalmology recommends conjunctival cultures be taken from all cases of suspected neonatal bacterial conjunctivitis [ 7 ]. Conjunctivitis in a newborn can pose a risk for the development of secondary ocular infections, including endophthalmitis and keratitis (in cases of gonococcal etiology) [ 1 , 8 ], permanent eye damage, and even blindness, although the latter is rare in industrialized countries [ 8 ]. Systemic complications such as pneumonitis, meningitis, and septicemia are also possible [ 1 , 2 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Besifloxacin Ophthalmic Suspension 0.6% Compared with Gatifloxacin Ophthalmic Solution 0.3% for the Treatment of Bacterial Conjunctivitis in Neonates

Sanfilippo¹,

Allaire

DeCory³

2017

Drugs R D

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PurposeThe aim of this study was to evaluate the safety and efficacy of topical besifloxacin ophthalmic suspension 0.6% compared with gatifloxacin ophthalmic solution 0.3% in the treatment of bacterial conjunctivitis in neonates.MethodsThis was a multicenter, randomized, double-masked, parallel group study. Subjects ≤31 days of age with severity grade ≥1 (scale 0–3) for both conjunctival discharge and conjunctival hyperemia were randomized to besifloxacin or gatifloxacin instilled three times daily for 7 days, and completed five study visits (three clinic visits and two phone calls). Primary endpoints included clinical resolution (absence of both conjunctival discharge and conjunctival hyperemia) at visit 5 (day 8 or 9) and ocular and non-ocular treatment-emergent adverse events (AEs). Bacterial eradication was a secondary endpoint.ResultsThirty-three subjects were included in the intent-to-treat (ITT) population. All were aged <28 days, with a mean (standard deviation) age of 15.5 days (6.0), and 57.6% were female. Twenty-two subjects had culture-confirmed conjunctivitis in at least one eye (modified ITT [mITT] population), most often with Gram-positive bacteria. Visit 5 clinical resolution and bacterial eradication rates were comparable among besifloxacin- and gatifloxacin-treated study eyes (clinical resolution: 12/16 [75.0%] vs. 12/17 [70.6%] for the ITT population, and 11/13 [84.6%] vs. 7/9 [77.8%] for the mITT population; bacterial eradication: 12/13 [92.3%] vs. 8/9 [88.9%] for the mITT population, respectively). No AEs were reported in the besifloxacin treatment group, and AEs reported in the gatifloxacin group were considered not treatment-related.ConclusionsIn this small study in neonates, both besifloxacin and gatifloxacin appeared effective and safe in the treatment of bacterial conjunctivitis. Larger studies are warranted.

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An Update on Neonatal and Pediatric Conjunctivitis

Cited by 5 publications

References 76 publications

The safety profile of Bald’s eyesalve for the treatment of bacterial infections

The safety profile of Bald’s eyesalve for the treatment of bacterial infections

Challenges in treating ophthalmia neonatorum

Besifloxacin Ophthalmic Suspension 0.6% Compared with Gatifloxacin Ophthalmic Solution 0.3% for the Treatment of Bacterial Conjunctivitis in Neonates

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