Treatment Overview

Seeing a newborn baby with red, swollen eyes or sticky discharge can be a frightening experience for any parent. Known medically as ophthalmia neonatorum, neonatal conjunctivitis occurs within the first month of life and is one of the most common eye conditions in infants. While a “sticky eye” is often caused by a simple blocked tear duct, true infections can progress rapidly and cause significant discomfort. Parents may notice their baby is fussy, sensitive to light, or has eyelids that are stuck together after sleep.

Treatment is critical not only to relieve the baby’s distress but to prevent potential vision loss or systemic illness. The eyes of a newborn are very delicate, and severe infections can damage the cornea if left unchecked. Because the condition can stem from various causes, ranging from irritation caused by eye drops given at birth to serious bacterial or viral infections acquired during delivery, treatment plans are not one-size-fits-all. Doctors must first determine the specific cause to prescribe the correct medication (Centers for Disease Control and Prevention, 2021).

Overview of treatment options for Neonatal Conjunctivitis

The treatment approach for neonatal conjunctivitis depends entirely on the underlying pathogen. The main goals are to eliminate the infection, reduce inflammation, and prevent complications such as pneumonia or corneal scarring.

If the cause is a blocked tear duct, gentle massage is often the only treatment needed. However, for infectious causes, medication is mandatory. Doctors distinguish between chemical irritation (which usually resolves on its own), bacterial infections (common skin bacteria or sexually transmitted bacteria), and viral infections. While topical drops are sufficient for mild cases caused by common skin bacteria, systemic treatment (medication taken by mouth or injection) is often required for infections caused by pathogens like Chlamydia trachomatis or Neisseria gonorrhoeae.

Medications used for Neonatal Conjunctivitis

Antibiotics form the core of treatment for bacterial conjunctivitis. For mild infections caused by skin bacteria like Staphylococcus, doctors typically prescribe topical antibiotic ointments or drops, such as erythromycin or gentamicin. These are applied directly to the eye several times a day.

However, if the infection is caused by Chlamydia, topical treatment alone is insufficient. Clinical experience suggests that oral antibiotics, specifically macrolides like erythromycin or azithromycin, are necessary to clear the infection and prevent associated complications like pneumonia.

For severe cases caused by Gonorrhea, treatment is more aggressive due to the risk of rapid blindness. This typically involves a single dose of a cephalosporin antibiotic, such as ceftriaxone or cefotaxime, administered intravenously (IV) or as an intramuscular (IM) injection. Frequent saline irrigation of the eye is also used to wash away discharge.

In rare cases where the infection is viral, caused by the herpes simplex virus, doctors prescribe antiviral medications like acyclovir. This is usually administered intravenously to prevent the virus from spreading to the brain or other organs (MedlinePlus, 2022).

How these medications work

Antibiotics work by attacking the structural integrity or reproductive capabilities of bacteria. Macrolides (like erythromycin) inhibit the bacteria’s ability to produce proteins essential for growth, effectively stopping the infection in its tracks. Cephalosporins (like ceftriaxone) disrupt the formation of the bacterial cell wall, causing the bacteria to rupture and die.

By eliminating the bacterial load, these drugs stop the production of toxins that cause swelling and pus. This allows the delicate tissues of the eye to heal and prevents permanent scarring of the cornea. Systemic medications circulate through the body to ensure that any bacteria harboring in the nose or lungs are also eradicated, providing a complete cure rather than just treating the surface symptoms.

Side effects and safety considerations

While these treatments are vision-saving, they carry potential risks. Oral erythromycin in newborns is linked to hypertrophic pyloric stenosis (stomach blockage); watch for forceful vomiting. Topical eye treatments can cause minor, temporary eyelid irritation.

IV antibiotics and antivirals are given in a hospital for monitoring. Common side effects include diarrhea or rash. Complete the full course of medication. Seek immediate medical attention if the baby develops a fever, refuses to eat, or if eye swelling worsens despite treatment. (Mayo Clinic, 2023).

Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

  1. Centers for Disease Control and Prevention. https://www.cdc.gov
  2. Mayo Clinic. https://www.mayoclinic.org
  3. MedlinePlus. https://medlineplus.gov
  4. American Academy of Ophthalmology. https://www.aao.org

Medications for Neonatal Conjunctivitis

These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Neonatal Conjunctivitis.

Found 1 Approved Drug for Neonatal Conjunctivitis

Ery-Ped

Generic Name
Ethylsuccinate

Ery-Ped

Generic Name
Ethylsuccinate
Form: Tablet, Granule, Suspension, For
Method of administration: Oral
FDA approval date: April 18, 2011
Classification: Macrolide
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Erythromycin Ethylsuccinate and other antibacterial drugs, Erythromycin Ethylsuccinate should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Erythromycin Ethylsuccinate is indicated in the treatment of infections caused by susceptible strains of the designated organisms in the diseases listed below: Upper respiratory tract infections of mild to moderate degree caused by Streptococcus pyogenes, Streptococcus pneumoniae, or Haemophilus influenzae (when used concomitantly with adequate doses of sulfonamides, since many strains of H. influenzae are not susceptible to the erythromycin concentrations ordinarily achieved). (See appropriate sulfonamide labeling for prescribing information.) Lower-respiratory tract infections of mild to moderate severity caused by Streptococcus pneumoniae or Streptococcus pyogenes. Listeriosis caused by Listeria monocytogenes. Pertussis (whooping cough) caused by Bordetella pertussis. Erythromycin is effective in eliminating the organism from the nasopharynx of infected individuals rendering them noninfectious. Some clinical studies suggest that erythromycin may be helpful in the prophylaxis of pertussis in exposed susceptible individuals. Respiratory tract infections due to Mycoplasma pneumoniae. Skin and skin structure infections of mild to moderate severity caused by Streptococcus pyogenes or Staphylococcus aureus (resistant staphylococci may emerge during treatment). Diphtheria Infections due to Corynebacterium diphtheriae, as an adjunct to antitoxin, to prevent establishment of carriers and to eradicate the organism in carriers. Erythrasma In the treatment of infections due to Corynebacterium minutissimum. Intestinal amebiasis caused by Entamoeba histolytica (oral erythromycins only). Extraenteric amebiasis requires treatment with other agents. Acute Pelvic Inflammatory Disease caused by Neisseria gonorrhoeae As an alternative drug in treatment of acute pelvic inflammatory disease caused by N. gonorrhoeae in female patients with a history of sensitivity to penicillin. Patients should have a serologic test for syphilis before receiving erythromycin as treatment of gonorrhea and a follow-up serologic test for syphilis after 3 months. Syphilis caused by Treponema pallidum Erythromycin is an alternate choice of treatment for primary syphilis in penicillin-allergic patients. In primary syphilis, spinal fluid examinations should be done before treatment and as part of follow-up after therapy. Erythromycins are indicated for the treatment of the following infections caused by Chlamydia trachomatis Conjunctivitis of the newborn, pneumonia of infancy, and urogenital infections during pregnancy. When tetracyclines are contraindicated or not tolerated, erythromycin is indicated for the treatment of uncomplicated urethral, endocervical, or rectal infections in adults due to Chlamydia trachomatis. When tetracyclines are contraindicated or not tolerated, erythromycin is indicated for the treatment of nongonococcal urethritis caused by Ureaplasma urealyticum. Legionnaires' Disease caused by Legionella pneumophila Although no controlled clinical efficacy studies have been conducted, in vitro and limited preliminary clinical data suggest that erythromycin may be effective in treating Legionnaires' Disease. Prophylaxis Prevention of Initial Attacks of Rheumatic Fever Penicillin is considered by the American Heart Association to be the drug of choice in the prevention of initial attacks of rheumatic fever (treatment of Streptococcus pyogenes infections of the upper respiratory tract, e.g., tonsillitis or pharyngitis). Erythromycin is indicated for the treatment of penicillin-allergic patients. 1 The therapeutic dose should be administered for 10 days. Prevention of Recurrent Attacks of Rheumatic Fever Penicillin or sulfonamides are considered by the American Heart Association to be the drugs of choice in the prevention of recurrent attacks of rheumatic fever. In patients who are allergic to penicillin and sulfonamides, oral erythromycin is recommended by the American Heart Association in the long-term prophylaxis of Streptococcal pharyngitis (for the prevention of recurrent attacks of rheumatic fever). 1.
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