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Template:Neonatal conjunctivitis treatment
From WikEM
Contents
Prophylaxis
Erythromycin 0.5% ointment x1 or Tetracycline 1% or Silver Nitrate 1% x1 topical, applied at birth.
Chemical
- Watchful waiting
Gonococcal (onset 2-4 days)
- Cefotaxime 100mg/kg IV or IM OR ceftriaxone 25-50mg/kg IV or IM x1 (not to exceed 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 3-10 days)
- Azithromycin 20mg/kg PO once daily x 3 days OR
- Erythromycin 50mg/kg PO QD in 4 divided doses x 14 days
- Disease manifests 5 days post-birth to 2 weeks (late onset)
- Topical treatment is unnecessary
Herpetic (onset 6-14 days)
- Acyclovir 20mg/kg IV q8hr x 14-21d
- Topical antiviral
- Full neonatal sepsis evaluation
- Immediate ophtho consult
