Template:Neonatal conjunctivitis treatment: Difference between revisions

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

@@ Line 1: / Line 1: @@
-===[[Gonococcal]]===
+===Prophylaxis===
-*Cefotaxime 100mg/kg IV or IM OR [[ceftriaxone]] 25-50mg/kg IV or IM x1 (not to exceed 125mg)
+*[[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
-**Topical treatment is unnecessary
+**Treat mother and partners
-===[[Chlamydia]]===
+**Irrigate eyes with saline (topical antibiotics are insufficient and unnecessary)
-*[[Azithromycin]] 20mg/kg PO once daily x 3 days OR
-*[[Erythromycin]] 50mg/kg PO QD in 4 divided doses x 14 days
+===[[Chlamydia]] (onset 5-10 days)===
-**Disease manifests 5 days post-birth to 2 weeks (late onset)
+*[[Erythromycin]] ophthalmic ointment plus one of the following
-*Topical treatment is unnecessary
+**[[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|Herpes]]===
+===[[Herpes|Herpetic]] (onset 6-14 days)===
-*Acyclovir 20mg/kg IV q8hr x 14-21d
+*[[Acyclovir]] 20mg/kg IV q8hr x 14-21d
 *Topical antiviral
-*Full sepsis evaluation
+*Do not give steroids
+*Full [[neonatal sepsis]] evaluation
-===Chemical===
+*Immediate ophtho consult
-*Watchful waiting