Ophthalmia neonatorum treatment and prophylaxis: IPOSC global study

Zloto, Ofira; Gharaibeh, Almutez; Mezer, Eedy; Stanković, Branislav; Isenberg, Sherwin J.; Wygnanski–Jaffe, Tamara

doi:10.1007/s00417-016-3274-5

Cited by 23 publications

(37 citation statements)

References 20 publications

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“…Ophthalmia neonatorum is a relatively common condition that can be caused by chemicals, bacteria, or viruses and affects between 1.6–12% of all newborn infants, and up to 23% of newborn infants in developing countries [ 1 – 6 ]. The prevalence of ophthalmia neonatorum varies in different parts of the world and is closely associated with socioeconomic conditions, the level of general health education, the standard of maternal healthcare, as well as the implementation of prevention programmes [ 3 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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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.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…Monocaprin is able to rapidly kill N. gonorrhoeae , N. meningitidis , and C. trachomatis [ 32 ], and has bactericidal activity against S. aureus and P. aeruginosa , making it a promising active ingredient for ocular prophylaxis and treatment to prevent the loss of vision due to eye infections. The ever-decreasing treatment options for N. gonorrhoeae [ 16 ], the rapid development of corneal melt and perforation [ 34 ], the potentially fatal consequences for N. meningitidis ocular infection dissemination [ 7 ], and the possibility of multi-species infection [ 22 ] support the development of a monocaprin-based formulation for prophylaxis and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…A study of the members of the American Association of Pediatric Ophthalmology and Strabismus revealed that most clinicians (85%) treated empirically [ 22 ]. It is, therefore, key that treatments are able to kill the potential causes of infant eye infections, including N. gonorrhoeae , Chlamydia trachomatis , Pseudomonas aeruginosa , and Staphylococcus aureus [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

“…It is, therefore, preferable if an ophthalmia neonatorum prophylaxis and treatment is effective against the major causes of bacterial eye infections. Most clinicians (85%) treat topically, as well as systemically [ 22 ]. However, universal ocular prophylaxis was abandoned in Denmark, Norway, Sweden, and the United Kingdom (UK), in favor of risk-factor-based screening of mothers [ 24 ]; however, this decision may be revisited in the face of untreatable gonorrhea and the rising incidence of infection.…”

Section: Introductionmentioning

confidence: 99%

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The Growing Threat of Gonococcal Blindness

et al. 2018

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Antibiotic-resistant gonorrhea is now a reality, as well as the consequences of untreatable infections. Gonococcal eye infections result in blindness if not properly treated; they accounted for the vast majority of infections in children in homes for the blind in the pre-antibiotic era. Neisseria gonorrhoeae infects the eyes of infants born to mothers with gonorrhea and can also infect the eyes of adults. Changes in sexual practices may account for the rise in adult gonococcal eye infections, although some cases seem to have occurred with no associated genital infection. As gonorrhea becomes increasingly difficult to treat, the consequences for the treatment of gonococcal blindness must be considered as well. Monocaprin was shown to be effective in rapidly killing N. gonorrhoeae, and is non-irritating in ocular models. Repeated passage in sub-lethal monocaprin induces neither resistance in gonococci nor genomic mutations that are suggestive of resistance. Here, we show that 1 mM monocaprin kills 100% of N. gonorrhoeae in 2 min, and is equally effective against N. meningitidis, a rare cause of ophthalmia neonatorum that is potentially lethal. Monocaprin at 1 mM also completely kills Staphylococcus aureus after 60 min, and 25 mM kills 80% of Pseudomonas aeruginosa after 360 min. Previously, 1 mM monocaprin was shown to eliminate Chlamydia trachomatis in 5 min. Monocaprin is, therefore, a promising active ingredient in the treatment and prophylaxis of keratitis, especially considering the growing threat of gonococcal blindness due to antimicrobial resistance.

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“…In 2015 in Canada, the rate of reported cases of chlamydial infection in children aged less than 1 year was approximately 10 per 100000 [ 17 ]. A 2017 survey of approximately 300 pediatric ophthalmologists, primarily in North America, estimated the number of neonatal conjunctivitis cases, most commonly caused by C trachomatis , to be up to 5 per practitioner per year [ 7 ]. Because of the continued high prevalence of chlamydia worldwide and the lack of prenatal screening in certain countries, a need for safe and effective therapies for infants who acquire a chlamydial infection remains.…”

mentioning

confidence: 99%

Treatment of Neonatal Chlamydial Conjunctivitis: A Systematic Review and Meta-analysis

Zikic

Lincetto

et al. 2018

Journal of the Pediatric Infectious Diseases Society

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Ophthalmia neonatorum treatment and prophylaxis: IPOSC global study

Abstract: We found that the incidence of ON per year per practitioner is 0-5 cases, the most common etiology is C. trachomatis, and most infants receive prophylaxis and treatment.

Cited by 23 publications

References 20 publications

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

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

The Growing Threat of Gonococcal Blindness

Treatment of Neonatal Chlamydial Conjunctivitis: A Systematic Review and Meta-analysis

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