Template:Neonatal conjunctivitis treatment: Difference between revisions
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===Prophylaxis=== | ===Prophylaxis=== | ||
Erythromycin 0.5% ointment x1 or | *[[Erythromycin]] 0.5% ointment x1 or [[tetracycline]] 1% or silver nitrate 1% x1 topical (rarely used because of its potential for causing chemical conjunctivitis), applied at birth. | ||
===Chemical=== | ===Chemical=== | ||
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===[[Gonococcal]] (onset 2-4 days)=== | ===[[Gonococcal]] (onset 2-4 days)=== | ||
*Cefotaxime 100mg/kg IV or IM OR [[ceftriaxone]] 25-50mg/kg IV or IM x1 (not to exceed 125mg) | *[[Cefotaxime]] 100mg/kg IV or IM OR [[ceftriaxone]] 25-50mg/kg IV or IM x1 (not to exceed 125mg) | ||
**Cefotaxime is preferred because it does not displace bilirubin | **Cefotaxime is preferred because it does not displace bilirubin | ||
**Disseminated disease should be suspected until CSF is negative | **Disseminated disease should be suspected until CSF is negative | ||
**Treat mother and partners | **Treat mother and partners | ||
**Irrigate eyes with saline (topical antibiotics are insufficient and unnecessary) | **Irrigate eyes with saline (topical antibiotics are insufficient and unnecessary) | ||
===[[Chlamydia]] (onset | ===[[Chlamydia]] (onset 5-10 days)=== | ||
*[[Azithromycin]] 20mg/kg PO once daily x 3 days OR | *[[Erythromycin]] ophthalmic ointment plus one of the following | ||
*[[Erythromycin]] 50mg/kg PO QD in 4 divided doses x 14 days | **[[Azithromycin]] 20mg/kg PO once daily x 3 days OR | ||
**[[Erythromycin]] 50mg/kg PO QD in 4 divided doses x 14 days | |||
*Disease manifests 5 days post-birth to 2 weeks (late onset) | |||
===[[Herpes|Herpetic]] (onset 6-14 days)=== | ===[[Herpes|Herpetic]] (onset 6-14 days)=== | ||
*Acyclovir 20mg/kg IV q8hr x 14-21d | *[[Acyclovir]] 20mg/kg IV q8hr x 14-21d | ||
*Topical antiviral | *Topical antiviral | ||
*Do not give steroids | |||
*Full [[neonatal sepsis]] evaluation | *Full [[neonatal sepsis]] evaluation | ||
*Immediate ophtho consult | *Immediate ophtho consult | ||
Latest revision as of 06:21, 31 July 2024
Prophylaxis
- Erythromycin 0.5% ointment x1 or tetracycline 1% or silver nitrate 1% x1 topical (rarely used because of its potential for causing chemical conjunctivitis), applied at birth.
Chemical
- Watchful waiting
Gonococcal (onset 2-4 days)
- Cefotaxime 100mg/kg IV or IM OR ceftriaxone 25-50mg/kg IV or IM x1 (not to exceed 125mg)
- Cefotaxime is preferred because it does not displace bilirubin
- Disseminated disease should be suspected until CSF is negative
- Treat mother and partners
- Irrigate eyes with saline (topical antibiotics are insufficient and unnecessary)
Chlamydia (onset 5-10 days)
- Erythromycin ophthalmic ointment plus one of the following
- Azithromycin 20mg/kg PO once daily x 3 days OR
- Erythromycin 50mg/kg PO QD in 4 divided doses x 14 days
- Disease manifests 5 days post-birth to 2 weeks (late onset)
Herpetic (onset 6-14 days)
- Acyclovir 20mg/kg IV q8hr x 14-21d
- Topical antiviral
- Do not give steroids
- Full neonatal sepsis evaluation
- Immediate ophtho consult