For all neonates it is recommended topical ocular prophylaxis for the prevention of gonococcal (Neisseria gonorrhoeae) and chlamydial (Chlamydia trachomatis) ophthalmia neonatorum.
When these bacterias are present in the genital tract of the pregnant woman, even if she is an asymptomatic carrier, she can transmit them to the newborn during delivery. When this occurs, it causes conjunctivitis in the baby, which generates reddening of the conjunctivae, inflammation of the eyelids and discharge. Gonococcal conjunctivitis can progress to generalized infections and can cause corneal ulcers and even blindness. For these reasons, after the first postnatal hour, when the newborn has completed colostrum intake, it is recommended one of the following options for topical application to both eyes immediately after birth:
— tetracycline hydrochloride 1% eye ointment
— erythromycin 0.5% eye ointment
— povidone iodine 2.5% solution (water-based)
— silver nitrate 1% solution
— chloramphenicol 1% eye ointment.
Cost and local resistance to erythromycin, tetracycline and chloramphenicol in gonococcal infection may determine the choice of medication. Caution should be taken to avoid touching eye tissue when applying the topical treatment and to provide a water-based solution of povidone iodine.
