Interventions for preventing ophthalmia neonatorum

Kapoor, Vimal; Whyte, Robin; Vedula, Satyanarayana S

doi:10.1002/14651858.cd001862.pub3

Cited by 6 publications

(7 citation 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 (26–28). 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%

“…Key candidate for future testing could include diabetic foot ulcers with a treatment cost average of £7800 per infection annually in the UK (33). Other potential treatment target include neonatal conjunctivitis, a major cause of childhood corneal blindness in developing countries (26). Our results are very promising, and the next steps would be to perform rigorous topical testing on healthy humans to determine any potential irritation or toxicity.…”

Section: Discussionmentioning

confidence: 99%

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

Anonye

Nweke

Furner-Pardoe

et al. 2020

Preprint

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22The rise in antimicrobial resistance has prompted the development of alternatives, 23 such as plant-derived compounds, to combat bacterial infections. Bald's eyesalve, a 24 remedy used in the Early Medieval period, has previously been shown to have efficacy 25 against Staphylococcus aureus grown in an in vitro model of soft tissue infection. This 26 remedy also had bactericidal activity against methicillin-resistant S. aureus (MRSA) in 27 a chronic mouse wound. However, the safety profile of Bald's eyesalve has not yet 28 been demonstrated, and this is vital before testing in humans. Here, we determined 29 the safety potential of Bald's eyesalve using in vitro, ex vivo, and in vivo models 30 representative of skin or eye infections. We also confirmed that Bald's eyesalve is 31 active against an important eye pathogen, Neisseria gonorrhoeae. Low levels of 32 cytotoxicity were observed in eyesalve-treated cell lines representative of skin and 33 immune cells. Results from a bovine corneal opacity and permeability test 34 demonstrated slight irritation to the cornea that resolved within 10 minutes. The slug 35 mucosal irritation assay revealed that a low level of mucus was secreted by slugs 36 exposed to eyesalve, indicating mild mucosal irritation. We obtained promising results 37 from mouse wound closure experiments; no visible signs of irritation or inflammation 38 were observed. Our results suggest that Bald's eyesalve could be tested further on 39 human volunteers to assess safety for topical application against bacterial infections. 40 41 Importance: Alternative treatment for bacterial infections are needed to combat the 42 ever increasing repertoire of bacteria resistant to antibiotics. A medieval plant-based 43 remedy, Bald's eyesalve, shows promise as a substitute for the treatment of these 44infections. For any substance to be effective in the treatment of bacterial infections in 45 humans, it is important to consider the safety profile. This is a key consideration in 46 3 order to have the necessary regulatory approval. We demonstrate the safety profile of 47 Bald's eyesalve using a variety of models, including whole-organ and whole-animal 48 models. Our results show that Bald's eyesalve is mildly toxic to cultured human cells, 49 but potentially suitable for patch tests on healthy human volunteers to assess safety 50 for later clinical trials. Our work has the potential to transform the management of 51 diseases caused by bacterial infections, such as diabetic foot ulcers, through topical 52 application of a natural product cocktail based on Bald's eyesalve. 53 54

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Anonye

Nweke

Furner-Pardoe

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…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%

“…Key candidates for future testing could include diabetic foot ulcers with a treatment cost average of £7800 per infection annually in the UK 33 . Other potential treatment target include neonatal conjunctivitis, a major cause of childhood corneal blindness in developing countries 26 . Our results are very promising, and the next steps would be to perform rigorous topical testing on healthy humans to determine any potential irritation or toxicity.…”

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

View full text Add to dashboard Cite

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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“…Ophthalmia neonatorum can be caused by the sexually transmitted pathogens of Neisseria gonorrhoeae and Chlamydia trachomatis, by bacteria such as Staphylococcus species, Streptococcus species, Haemophilus species and other gram-negative bacterial species, or much less commonly by viral infections (herpes simplex and adenovirus virus). The organisms inducing ophthalmia neonatorum are usually acquired during the birth process, from the mother's birth canal, or after birth from the immediate surroundings (2)(3)(4). Epidemiology of organisms that induce ophtalmia neonatorum substantially differs between developing countries and developed countries (3).…”

Section: Introductionmentioning

confidence: 99%

Euphrasia Eye Drops in Preterm Neonates With Ocular Discharge: A Randomized Double-Blind Placebo-Controlled Trial

et al. 2020

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Aim: To investigate whether the early administration of Euphrasia eye drops ® in preterm neonates presenting with ocular discharge fosters the resolution of the ocular discharge and reduces the need for topical antibiotic therapy, as compared to placebo. Methods: We conducted a randomized double-blind placebo-controlled trial at the University Children's Hospital Bern, Switzerland. Preterm neonates with white, yellow, or green ocular discharge were included. Infants were randomly assigned (1:1) to the Euphrasia arm (Euphrasia eye drops ® , Weleda AG, Arlesheim) or the placebo arm (NaCl 0.9%). Euphrasia or placebo was administrated at a dose of one drop in each eye four times a day over a period of 96 h. The primary outcome was the treatment success, defined as no ocular discharge at 96 h and no use of topical antibiotic therapy during the 96-h intervention. Results: A total of 114 neonates were screened and 84 were randomized. Among neonates in the Euphrasia arm, 22 (55.0%) achieved our primary outcome compared to 21 (51.2%) in the placebo arm (p = 0.85). In the Euphrasia arm, time to resolution of reddening tended to fall within the shorter bracket of 24 to 48 h (24 (92.3%) vs. 12 (80.0%) in the placebo arm, p = 0.34) and relapse or first signs of reddening during the 96-h intervention tended to be lower [3 (7.9%) eyes vs. 8 (18.2%) eyes in the placebo arm, p = 0.17]. Tearing at 96 h tended to be lower in the Euphrasia arm [5 (12.8%) eyes in the Euphrasia arm vs. 12 (27.3%) eyes in the placebo arm, p = 0.10]. Discussion: Euphrasia did not significantly improve treatment success, defined as no ocular discharge at 96 h and no use of topical antibiotic therapy during the 96-h intervention. However, results suggest that Euphrasia may be of benefit for symptoms such as reddening and tearing, and thus improve the comfort of patients. Trial Registration: The trial is registered at the US National Institutes of Health (ClinicalTrials.gov) NCT04122300 and at the portal for human research in Switzerland SNCTP000003490.

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Interventions for preventing ophthalmia neonatorum

Abstract: Interventions for preventing ophthalmia neonatorum.

Cited by 6 publications

References 50 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

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

Euphrasia Eye Drops in Preterm Neonates With Ocular Discharge: A Randomized Double-Blind Placebo-Controlled Trial

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