NEONATAL CONJUNCTIVITIS

Question 1

Neonatal conjunctivitis

Answer 1

Neonatal conjunctivitis or ophthalmia neonatorum is an acute purulent conjunctivitis during the first month of life.

Question 2

How does the neonate get neonatal conjunctivitis

Answer 2

Contracted from infected genital secretions of the mother

Question 3

Prevention of neonatal conjunctivitis

Answer 3

1. Cleaning of the neonate’s eyes immediately after birth
2. Application of 1% tetracycline ointment into the eyes

Question 4

Causative agents of neonatal conjunctivitis

Answer 4

Neisseria gonorrhoea
Chlamydia trachomatis
Staphylococci
Streptococci
Herpes Simplex virus
Chemical e.g. silver nitrate

Question 4

Symptoms of neonatal conjunctivitis

Answer 4

Eye discharge
Swelling of the eyelids

Question 5

Signs of neonatal conjunctivitis

Answer 5

Eye discharge, may be purulent
Redness of conjunctiva
Swelling of conjunctiva
Oedema of eyelids
Redness of the eyelids

Question 6

Treatment objectives in neonatal conjunctivitis

Answer 6

To treat the infection
To prevent blindness

Question 6

Investigations in neonatal conjunctivitis

Answer 6

Conjunctival swabs for gram staining and culture

Question 7

Non-pharmacological interventions in neonatal conjunctivitis

Answer 7

Clean the eyelids frequently (every 2 hours) with cotton wool dipped in sterile saline solution. In the absence of sterile saline solution, use boiled water that has been left to cool

Question 8

Treatment of the baby with neonatal conjunctivitis

Answer 8

Ceftriazone or Cefotaxime
and
Erythromycin
And
Chloramphenicol eye drops, 0.5% applied to each eye every 2 hours for 48 hours (after cleaning away discharge-saline irrigation)
Then
Chloramphenicol eye drops, 0.5% applied to each eye 6 hourly
And
Chloramphenicol eye ointment, 1% applied to each eye at night

Question 9

Dose of ceftriaxone given to the baby for neonatal conjunctivitis

Answer 9

Ceftriaxone IM or IV, 25-50 mg/kg stat. (max. 125 mg)

Question 10

Dose of cefotaxime given to the baby for neonatal conjunctivitis

Answer 10

Cefotaxime, IM, 100 mg/kg stat.

Question 11

Dose of erythromycin given to the baby for neonatal conjunctivitis

Answer 11

Erythromycin, oral, 12.5 mg/kg 6 hourly for 14 days

Question 12

Dose of chloramphenicol eye drop given to the baby for neonatal conjunctivitis

Answer 12

0.5% applied to each eye
Every 2 hours for 48 hours (after cleaning away discharge-saline irrigation)
then
Every 6 hours

Question 13

Dose of chloramphenicol ointment given to neonates for neonatal conjunctivitis

Answer 13

Chloramphenicol eye ointment, 1% applied to each eye at night

Question 14

Treatment of the mother of the baby with neonatal conjnctivitis

Answer 14

Ceftriaxone, IM, 250 mg stat.
And
Erythromycin, oral, 500 mg 6 hourly for 7 days

Question 15

In neonatal conjunctivitis, what treatment is given to mother’s partner(s) for gonorrhoea and chlamydia

Answer 15

Ceftriaxone or Cefixime or Ciprofloxacin
and
Doxycycline or Tetracycline or Erythromycin or Azithromycin

Question 16

Dose of ceftriaxone for gonorrhoea and chlamydia

Answer 16

IM, 250mg stat

Question 17

Dose of cefixime for gonorrhoea and chlamydia

Answer 17

PO 400mg stat

Question 18

Dose of ciprofloxacin for gonorrhoea and chlamydia

Answer 18

PO 500mg stat

Question 19

Dose of doxycycline for gonorrhoea and chlamydia

Answer 19

PO 100mg bd for 7 days

Question 20

Dose of tetracycline for gonorrhoea and chlamydia

Answer 20

PO 500mg 6 hourly for 7 days

Question 21

Dose of erythromycin for gonorrhoea and chlamydia

Answer 21

500mg 6 hourly for 7 days

Question 22

Dose of azithromycin for gonorrhoea and chlamydia

Answer 22

PO 1g stat