Template:Neonatal conjunctivitis treatment: Difference between revisions
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===Prophylaxis=== | ===Prophylaxis=== | ||
Erythromycin 0.5% ointment x1 or | *{{AntibioticDose|drug=Erythromycin|dose=0.5% ointment topical x1|context=Prophylaxis at birth|disease=Neonatal conjunctivitis|population=Pediatric}} 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 | *{{AntibioticDose|drug=Cefotaxime|dose=100mg/kg IV or IM x1|context=Gonococcal conjunctivitis|disease=Neonatal conjunctivitis|population=Pediatric}} OR {{AntibioticDose|drug=Ceftriaxone|dose=25-50mg/kg IV or IM x1 (max 125mg)|context=Gonococcal conjunctivitis|disease=Neonatal conjunctivitis|population=Pediatric}} | ||
**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 | ||
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===[[Chlamydia]] (onset 5-10 days)=== | ===[[Chlamydia]] (onset 5-10 days)=== | ||
* | *[[Erythromycin]] ophthalmic ointment plus one of the following | ||
** | **{{AntibioticDose|drug=Azithromycin|dose=20mg/kg PO once daily x 3 days|context=Chlamydial conjunctivitis|disease=Neonatal conjunctivitis|population=Pediatric}} OR | ||
** | **{{AntibioticDose|drug=Erythromycin|dose=50mg/kg PO daily in 4 divided doses x 14 days|context=Chlamydial conjunctivitis|disease=Neonatal conjunctivitis|population=Pediatric}} | ||
*Disease manifests 5 days post-birth to 2 weeks (late onset) | *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 | *{{AntibioticDose|drug=Acyclovir|dose=20mg/kg IV q8h x 14-21 days|context=Herpetic conjunctivitis|disease=Neonatal conjunctivitis|population=Pediatric}} | ||
*Topical antiviral | *Topical antiviral | ||
*Do not give steroids | *Do not give steroids | ||
*Full [[neonatal sepsis]] evaluation | *Full [[neonatal sepsis]] evaluation | ||
*Immediate ophtho consult | *Immediate ophtho consult | ||
Latest revision as of 22:29, 20 March 2026
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