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Neonatal prophylaxis with antibiotic containing ointments does not reduce incidence of chlamydial conjunctivitis in

Tamar A Smith-Norowitz1, Crystal Ukaegbu2,3, Stephan Kohlhoff2

  • 1Department of Pediatrics, State University of New York Downstate Medical Center, 450 Clarkson Ave., Box 49, Brooklyn, NY, 11203, USA. tamar.smith-norowitz@downstate.edu.

BMC Infectious Diseases
|March 18, 2021
PubMed

Insights

Antibiotic eye ointments like erythromycin or tetracycline do not prevent neonatal chlamydial conjunctivitis (NCC) or respiratory infections in infants born to mothers with Chlamydia trachomatis.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Ophthalmology

Background:

  • Silver nitrate prophylaxis is ineffective against Chlamydia trachomatis (CT) related neonatal conjunctivitis (NCC).
  • The efficacy of antibiotic preparations for preventing NCC remains unestablished.

Purpose of the Study:

  • To evaluate the effectiveness of antibiotic preparations in preventing NCC.
  • To determine if antibiotic prophylaxis prevents CT in the nasopharynx of neonates.

Main Methods:

  • Systematic literature search of MEDLINE and EMBASE.
  • Included prospective/comparative studies with maternal CT screening, infant follow-up, and CT testing in eyes/nasopharynx.
  • Three studies met all inclusion criteria.

Main Results:

  • CT conjunctivitis rates were 20-33% with silver nitrate, and 0-15% with erythromycin/tetracycline.
  • Nasopharyngeal CT positivity rates were 1-28% with silver nitrate and 4-33% with erythromycin/tetracycline.
  • Chlamydial pneumonia rates were 3-8% with silver nitrate and 0-4% with erythromycin/tetracycline.

Conclusions:

  • Erythromycin or tetracycline ophthalmic ointments do not reduce NCC incidence compared to silver nitrate.
  • Antibiotic prophylaxis did not significantly decrease respiratory CT infections in infants of CT-positive mothers.
Abstract

Keywords:
Chlamydia trachomatisErythromycinNeonatal chlamydial prophylaxisSilver nitrateTetracycline

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