• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

Cochrane Reviews: Prophylaxis for Preventing Ophthalmia Neonatorum

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Kapoor et al. (Cochrane Systematic Reviews, 2020) sought to determine if pharmacologic prophylaxis is superior to placebo for the prevention of ophthalmia neonatorum, and if so, which is the preferred medication

METHODS:

  • Systematic review and meta-analysis
    • Aside from usual database searches and reference checks, the authors also contacted pharmaceutical companies
  • Inclusion criteria
    • Randomized and quasi-randomized controlled trials
    • Studies that examined any topical, systemic, or combination medical interventions used to prevent ophthalmia neonatorum in newborns compared with placebo, no prophylaxis, or with each other
  • Study design
    • Study was conducted with standard Cochrane methods
  • Primary outcomes
    • Blindness or any adverse visual outcome at 12 months
    • Conjunctivitis at 1 month: Gonococcal (GC) | Chlamydial (CC) | Bacterial (BC) | Any etiology (ACAE) | Unknown etiology
    • Adverse effects

RESULTS:

  • 30 trials | 79,198 total neonates
    • High-income settings: 18 trials | Low- and middle-income settings: 12 trials
    • Total of 14 different prophylactic regimens and 12 different medications

Any Prophylaxis Compared to No Prophylaxis

  • Studies assessed one or more of the following
    • Tetracycline 1% | Erythromycin 0.5% | Povidone-iodine 2.5% | Silver nitrate 1%
  • None of the studies reported data on blindness or any adverse visual outcome
  • Low-certainty evidence regarding risk of GC with prophylaxis vs no prophylaxis at one month
    • Risk ratio (RR) 0.79 (95% CI, 0.24 to 2.65)
  • Low-certainty evidence suggested there may be little or no difference in effect on risk of
    • CC: RR 0.96 (95% CI, 0.57 to 1.61)
    • BC: RR 0.84 (95% CI, 0.37 to 1.93)
  • Moderate-certainty evidence suggested a probable reduction in risk of ACAE at one month
    • RR 0.65 (95% CI, 0.54 to 0.78)
  • There was very-low certainty evidence on the risk of CUE
    • RR 1.75 (95% CI, 0.37 to 8.28)
  • There was very low-certainty evidence of adverse effects, but the evidence suggested no increased risk for the following
    • Nasolacrimal duct obstruction: RR 0.93 (95% CI, 0.68 to 1.28)
    • Keratitis: Single study of 40 newborns assessing silver nitrate 1% with no events

Any Prophylaxis Compared to Another Prophylaxis

  • There was no consistently superior intervention
  • Most evidence was of low-certainty and very limited

CONCLUSION:

  • Serious outcomes
    • There is no data on whether taking prophylactic measures for ophthalmia neonatorum prevents blindness or adverse visual outcomes
  • Preventing conjunctivitis
    • The use of prophylaxis may lead to a reduction in the incidence of conjunctivitis of any etiology
    • The evidence on gonococcal, chlamydial, and bacterial conjunctivitis was less certain
  • The authors suggest a future trial to determine which medication works best

Learn More – Primary Sources:

Interventions for preventing ophthalmia neonatorum

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone, with ObGFirst

ObGFirst® – Try It Free! »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Practical obstetrics info for your women's healthcare practice
STI Screening in Pregnancy: CDC Recommendations
Chlamydia: CDC Recommendations for Diagnosis and Treatment

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site