Template:Neonatal conjunctivitis treatment

Prophylaxis

• Erythromycin 0.5% ointment topical 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 x1 OR Ceftriaxone 25-50mg/kg IV or IM x1 (max 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 daily 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 q8h x 14-21 days
• Topical antiviral
• Do not give steroids
• Full neonatal sepsis evaluation
• Immediate ophtho consult