Non-Gonococcal Ophthalmitis Associated with Erythromycin Ointment Prophylaxis of Gonococcal Ophthalmia Neonatorum

Abstract

Substitution of erythromycin ointment for silver nitrate in the prophylaxis of gonococcal ophthalmia neonatorum (GON) was accompanied by eight infections in 749 (1.1%) well-born and 21 infections in 285 (7.4%) intensive care infants during an eight-month period. This was significantly higher than previous rates of ophthalmitis during the use of silver nitrate, 0.3% (5/1877) and 2.1% (19/904) for well and intensive care infants, (P<0.01). Multiple bacteria were isolated, polymicrobial infection occurred frequently and the pattern of bacterial isolates did not favor cross-contamination between infants. Observation suggested the frequent unintentional introduction of ungloved fingers into neonatal eyes during attempts to insert erythromycin ointment. Replacement of ophthalmic ointment with a liquid tetracycline preparation resulted in a decrease in non-gonococcal ophthalmitis to rates similar to the baseline period 8/997 (0.8%) for both nurseries. The increased number of infections appear related to the ointment vehicle, difficulty in its application and the mechanical introduction of bacteria. It is inferred that appropriate application of liquid medication also reduced the risk of inadequate prophylaxis.

Types and drug susceptibility patterns of bacterial isolates from eye discharge samples at Gondar University Hospital, Northwest Ethiopia

“…Forty 40 (39.21%) samples were not showed bacterial growth. This might be due to the possibility of the presence of other micro-organisms which may cause eye infection such as viral causes or Chlamydia [ 17 ] or fungi causes especially yeasts [ 18 ].…”

A Controlled Trial of Povidone–Iodine as Prophylaxis against Ophthalmia Neonatorum

“…When used prophylactically, topical erythromycin has a failure rate of 7 to 19.5 percent. 10 Ophthalmia neonatorum has been reported more often after erythromycin prophylaxis than after silver nitrate treatment 11 and more often after silver nitrate treatment than after tetracycline treatment (P Ͻ 0.05). 12 Prophylaxis with erythromycin has resulted in outbreaks of erythromycin-resistant staphylococcal conjunctivitis in neonates.…”

Conjunctivitis in Neonates

“…Because the isolated organisms were different and cases occurred over the entire period of review, a single source was unlikely. Ten of the 12 cases had cultures of conjunctival exudate taken and organisms that were recovered included: Proteus species (1), Staphylococcus aureus (2), alpha streptococcus (2), Serratia marcescens (1), Haemophilus influenza (2), Escherichia coli (1), and Neisseria gonorrhoeae (1).…”