TABLE 33.

Prevention and Treatment of Ophthalmia Neonatorum

SourceLocation and Type of TrialInterventionPerinatal/Neonatal Outcome
Isenberg et al550Kenya; urban setting; RCT3117 newborns were enrolled and randomized to 1 of 3 groups to receive 2.5% povidone-iodine solution (n = 1076), 0.5% erythromycin ophthalmic ointment, (n = 1112), or a drop of 1% silver-nitrate ophthalmic solution (n = 929).13% of the infants in the povidone-iodine group, vs 17.5% of the infants in the silver-nitrate group (P < .001), and 15.2% of the infants in the erythromycin group (P = .01) had infectious conjunctivitis. Povidone-iodine was more effective against Chlamydia trachomatis than was silver nitrate (P < .001) or erythromycin (P = .008). Noninfectious conjunctivitis was less frequent among povidone-iodine-treated infants (9.7%) than those treated with silver-nitrate (13.9%, P < .001) or erythromycin group (13.3%, P = .004). Incidence of N gonorrhoeae and Staphylococcus aureus infections was similar in the 3 groups.
Laga et al541Kenya; urban setting; QT2732 infants were enrolled in 1 of 2 groups to have either 1% silver nitrate (n = 1233) or 1% tetracycline (n = 1499) instilled in their eyes. A historical cohort of newborns who did not receive eye prophylaxis were included as controls.Infection rates of gonococcal ophthalmia neonatorum in newborns exposed to N gonorrhoeae at birth were 7.0% in those receiving silver nitrate and 3.0% in those receiving tetracycline (CI: −3.4 to 11.4%). As compared with historical controls, the incidence of gonococcal ophthalmia neonatorum decreased 83% and 93% among infants treated with silver nitrate and those treated with tetracycline, respectively.