Neonatal Prophylaxis with Antibiotic Containing Ointments Does Not Reduce Incidence of Chlamydial Conjunctivitis in Newborns

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2021 Mar 18

PMID 33731049

Citations 3

Authors

Tamar A Smith-Norowitz

Crystal Ukaegbu

Stephan Kohlhoff

Margaret R Hammerschlag

Affiliations

Soon will be listed here.

Abstract

Background: Neonatal ocular prophylaxis with silver nitrate does not prevent neonatal conjunctivitis due to Chlamydia trachomatis. The efficacy of antibiotic containing preparations for prevention of neonatal chlamydial conjunctivitis (NCC) has not been established.

Objective: To examine published literature to determine whether antibiotic containing preparation are efficacious for prevention of NCC and C. trachomatis in the nasopharynx.

Methods: A literature search of MEDLINE and EMBASE. Articles were selected for review if their content included 4 key criteria: (1) Prospective/comparative study. (2) Prenatal screening of mothers for C. trachomatis with results reported. (3) Follow-up of infants born to chlamydia-positive women. (4) Infants prospectively followed at regular intervals and tested for C. trachomatis in the eye/ nasopharynx (NP).

Results: The search yielded 159 studies; 11 were selected for full reviews, eight were excluded; three addressed the four criteria. Rates of C. trachomatis conjunctivitis in infants in included studies who received silver nitrate was 20-33%; positive NP, 1-28% and pneumonia, 3-8%. Rates of C. trachomatis conjunctivitis in neonates who received erythromycin or tetracycline prophylaxis did not differ from silver nitrate; 0-15 and 11%, respectively, who received erythromycin or tetracycline developed NCC. Similarly, 4-33 and 5% of infants who received erythromycin or tetracycline, respectively, had positive NP cultures; 0-4% developed chlamydial pneumonia.

Conclusion: Neonatal ocular prophylaxis with erythromycin or tetracycline ophthalmic ointments does not reduce incidence of neonatal chlamydial conjunctivitis or respiratory infection in infants born to mothers with C. trachomatis infection compared to silver nitrate.

Citing Articles

Neisseria meningitidis: The Unforeseen Agent of Acute Neonatal Conjunctivitis.

Albuquerque C, Dias M, Pelicano M, Banganho D, Morais R Cureus. 2024; 16(7):e65681.

PMID: 39205736 PMC: 11357735. DOI: 10.7759/cureus.65681.

Intersociety Position Statement on the Prevention of Ophthalmia Neonatorum in Italy.

Tzialla C, Auriti C, Aversa S, Merazzi D, Martinelli S, Araimo G Microorganisms. 2024; 12(1).

PMID: 38276184 PMC: 10818411. DOI: 10.3390/microorganisms12010015.

Screening and Treatment in Pregnancy to Reduce Adverse Pregnancy and Neonatal Outcomes: A Review.

Adachi K, Nielsen-Saines K, Klausner J Front Public Health. 2021; 9:531073.

PMID: 34178906 PMC: 8222807. DOI: 10.3389/fpubh.2021.531073.

References

Ali Z, Khadije D, Elahe A, Mohammad M, Fateme Z, Narges Z . Prophylaxis of ophthalmia neonatorum comparison of betadine, erythromycin and no prophylaxis. J Trop Pediatr. 2007; 53(6):388-92. DOI: 10.1093/tropej/fmm049. View

Schachter J, Grossman M, Holt J, Sweet R, Goodner E, Mills J . Prospective study of chlamydial infection in neonates. Lancet. 1979; 2(8139):377-80. DOI: 10.1016/s0140-6736(79)90400-8. View

Laga M, Plummer F, Piot P, Datta P, Namaara W, Ndinya-Achola J . Prophylaxis of gonococcal and chlamydial ophthalmia neonatorum. A comparison of silver nitrate and tetracycline. N Engl J Med. 1988; 318(11):653-7. DOI: 10.1056/NEJM198803173181101. View

Lund R, Kibel M, Knight G, van der Elst C . Prophylaxis against gonococcal ophthalmia neonatorum. A prospective study. S Afr Med J. 1987; 72(9):620-2. View

Workowski K, Bolan G . Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015; 64(RR-03):1-137. PMC: 5885289. View

Nathawad R, Mendez H, Ahmad A, Laungani S, Hoa B, Garlick J . Severe ocular reactions after neonatal ocular prophylaxis with gentamicin ophthalmic ointment. Pediatr Infect Dis J. 2010; 30(2):175-6. DOI: 10.1097/INF.0b013e3181f6c2e5. View

Banniettis N, Wisecup K, Boland L, Watanabe I, Hammerschlag M, Kohlhoff S . Association of Routine Chlamydia trachomatis Screening During Pregnancy and Seroprevalence of Chlamydial Infection in Children, 1991-2015. J Pediatric Infect Dis Soc. 2020; 10(2):172-174. DOI: 10.1093/jpids/piaa002. View

David M, Rumelt S, Weintraub Z . Efficacy comparison between povidone iodine 2.5% and tetracycline 1% in prevention of ophthalmia neonatorum. Ophthalmology. 2011; 118(7):1454-8. DOI: 10.1016/j.ophtha.2010.12.003. View

Hammerschlag M, Smith-Norowitz T, Kohlhoff S . Keeping an Eye on Chlamydia and Gonorrhea Conjunctivitis in Infants in the United States, 2010-2015. Sex Transm Dis. 2017; 44(9):577. DOI: 10.1097/OLQ.0000000000000678. View

10.

Ramirez-Ortiz M, Rodriguez-Almaraz M, Ochoa-Diazlopez H, Diaz-Prieto P, Rodriguez-Suarez R . Randomised equivalency trial comparing 2.5% povidone-iodine eye drops and ophthalmic chloramphenicol for preventing neonatal conjunctivitis in a trachoma endemic area in southern Mexico. Br J Ophthalmol. 2007; 91(11):1430-4. PMC: 2095407. DOI: 10.1136/bjo.2007.119867. View

11.

Binenbaum G, Bruno C, Forbes B, Snyder M, Mollen T, Schmidt B . Periocular ulcerative dermatitis associated with gentamicin ointment prophylaxis in newborns. J Pediatr. 2010; 156(2):320-1. PMC: 2828447. DOI: 10.1016/j.jpeds.2009.11.060. View

12.

. Recommendations for the prevention and management of Chlamydia trachomatis infections, 1993. Centers for Disease Control and Prevention. MMWR Recomm Rep. 1993; 42(RR-12):1-39. View

13.

Adachi K, Nielsen-Saines K, Klausner J . Chlamydia trachomatis Infection in Pregnancy: The Global Challenge of Preventing Adverse Pregnancy and Infant Outcomes in Sub-Saharan Africa and Asia. Biomed Res Int. 2016; 2016:9315757. PMC: 4837252. DOI: 10.1155/2016/9315757. View

14.

Matinzadeh Z, Beiragdar F, Kavemanesh Z, Abolgasemi H, Amirsalari S . Efficacy of topical ophthalmic prophylaxis in prevention of ophthalmia neonatorum. Trop Doct. 2007; 37(1):47-9. DOI: 10.1258/004947507779951880. View

15.

Moore D, MacDonald N . Preventing ophthalmia neonatorum. Paediatr Child Health. 2015; 20(2):93-6. PMC: 4373584. View

16.

Hammerschlag M, Anderka M, Semine D, McComb D, McCormack W . Prospective study of maternal and infantile infection with Chlamydia trachomatis. Pediatrics. 1979; 64(2):142-8. View

17.

Kohlhoff S, Roblin P, Clement S, Banniettis N, Hammerschlag M . Universal Prenatal Screening and Testing and Chlamydia trachomatis Conjunctivitis in Infants. Sex Transm Dis. 2020; 48(9):e122-e123. DOI: 10.1097/OLQ.0000000000001344. View

18.

Hammerschlag M, Cummings C, Roblin P, Williams T, Delke I . Efficacy of neonatal ocular prophylaxis for the prevention of chlamydial and gonococcal conjunctivitis. N Engl J Med. 1989; 320(12):769-72. DOI: 10.1056/NEJM198903233201204. View

19.

Chen J . Prophylaxis of ophthalmia neonatorum: comparison of silver nitrate, tetracycline, erythromycin and no prophylaxis. Pediatr Infect Dis J. 1992; 11(12):1026-30. View

20.

Bell T, Sandstrom K, Gravett M, Mohan K, Kuo C, Stamm W . Comparison of ophthalmic silver nitrate solution and erythromycin ointment for prevention of natally acquired Chlamydia trachomatis. Sex Transm Dis. 1987; 14(4):195-200. DOI: 10.1097/00007435-198710000-00003. View