USPSTF Recommends Antibiotic Prophylaxis to Prevent Gonorrheal Eye Disease in Newborns Interview with:

Michael Silverstein, M.D., M.P.H. Professor of pediatrics Director of the Division of General Academic Pediatrics Vice chair of research for the Department of Pediatrics Boston University School of Medicine

Dr. Silverstein

Michael Silverstein, M.D., M.P.H.
Professor of Pediatrics
Director of the Division of General Academic Pediatrics
Vice chair of research for the Department of Pediatrics
Boston University School of Medicine What is the background for this study? What are the main findings?

Response: Gonococcal ophthalmia neonatorum, or GON, is a severe infection of the eye that can occur in babies born to women who have gonorrhea. If left untreated, GON can cause serious problems, including blindness, that can appear as soon as 24 hours after delivery.

Fortunately, there are effective treatments available that can prevent GON in newborns. The U.S. Preventive Services Task Force reviewed the most current research on the benefits and harms of ocular prophylaxis—which is applying antibiotic ointment to the babies’ eyes at birth—to prevent GON.

We found that, if applied within 24 hours after birth, the ointment is very effective at preventing gonococcal ophthalmia neonatorum and the problems it causes. Therefore, we are recommending that clinicians provide this preventive service for all newborns. What should readers take away from your report?

Response: We have seen a rise in gonorrhea infections over the past few years in the U.S. However, because it is the standard of care to provide preventive medications at birth, we have not seen an increase in rates of gonococcal ophthalmia neonatorum. We must ensure GON rates stay low in the U.S. by helping babies receive the care they need to live long, healthy lives. It is critical that clinicians apply antibiotic ointment to newborns’ eyes within 24 hours of birth to prevent gonococcal ophthalmia neonatorum and the complications it can cause. What recommendations do you have for future research as a result of this work?

Response: More research is needed on the benefits and harms of giving ocular prophylaxis only to babies who are at increased risk for gonococcal ophthalmia neonatorum. This would mean that not all newborns would receive preventive antibiotic ointment, just those born to mothers who have been diagnosed with or who are at risk for gonorrhea.

Additionally, we need more evidence on effective alternatives to erythromycin, the only gonococcal ophthalmia neonatorum treatment approved by the FDA. It has been used for more than 20 years, and there is some concern that the bacteria may become resistant to the antibiotic. Is there anything else you would like to add?

Response: Ocular prophylaxis is safe, effective, and has been helping keep babies healthy for years. Clinicians should continue to apply preventive antibiotic ointment to newborns’ eyes as soon as possible after birth to prevent gonococcal ophthalmia neonatorum. Anyone who is concerned about their newborn’s risk for gonococcal ophthalmia neonatorum should talk to their doctor.

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US Preventive Services Task Force. Ocular Prophylaxis for Gonococcal Ophthalmia NeonatorumUS Preventive Services Task Force Reaffirmation Recommendation StatementJAMA. 2019;321(4):394–398. doi:10.1001/jama.2018.21367 

Feb 5, 2019 @ 12:24 am

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