povidone-iodine and Gonorrhea

BACKGROUND Ophthalmia neonatorum, or neonatal conjunctivitis, is an acute infection that occurs within the first 28 days of life. This aim of this survey was to evaluate the current methods of preventive treatment for ophthalmia neonatorum in maternity hospitals in Croatia. MATERIAL AND METHODS The annual hospital birth rate in Croatia is approximately 40,000. A clinical survey was undertaken with data collected using questionnaires sent to all 32 maternity hospitals in Croatia. There was a 100% response rate to the questionnaires. RESULTS Preventive treatment for ophthalmia neonatorum was administrated to all newborns in 75% (24/32) of Croatian maternity hospitals. In 45.8% of maternity hospitals, (11/32) these procedures were performed within the first hour after birth. In 54.2% of maternity hospitals (13/32), preventive treatment for ophthalmia neonatorum was administrated to all newborns from one to three hours after birth. The main treatment agent was tobramycin (83.3%). Other topical prophylactic treatments included povidone-iodine (8.3%), erythromycin (4.2%), and silver nitrate (4.2%). In 25% of obstetric units, prophylaxis for ophthalmia neonatorum was not used routinely, but in cases of diagnosed neonatal conjunctivitis, antibiotic treatment with tobramycin was mainly used. CONCLUSIONS A survey of all 32 maternity hospitals in Croatia showed variation in the prevalence of preventive treatment for ophthalmia neonatorum and the methods used. These findings support the need to implement standardized preventive measures that both conform to international clinical guidelines and recognize treatment availability in Croatia, where topical povidone-iodine is currently preferred for the prevention of ophthalmia neonatorum.

Topics: Anti-Bacterial Agents; Croatia; Erythromycin; Female; Gonorrhea; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Neisseria gonorrhoeae; Ophthalmia Neonatorum; Povidone-Iodine; Pregnancy; Pregnancy Complications, Infectious; Prevalence; Silver Nitrate; Surveys and Questionnaires; Tobramycin

The recommendations for the 2010 Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines in regard to diagnosis and treatment of gonococcal and Chlamydia trachomatis infections in infants and children are essentially the same as the 2006 guidelines. There are no new data on the diagnosis or treatment of neonatal chlamydial or gonococcal infections. New data on the efficacy of neonatal ocular prophylaxis are limited. Two recent studies from Iran and Brazil suggest that povidone-iodine may not be effective for prevention of chlamydial or gonococcal ophthalmia. Prenatal screening and treatment of pregnant women, which has been demonstrated to be very effective for the prevention of neonatal gonococcal ophthalmia, is the most effective strategy for preventing neonatal chlamydial infection.

Topics: Anti-Infective Agents; Chemoprevention; Child; Child, Preschool; Chlamydia Infections; Chlamydia trachomatis; Eye Infections; Female; Gonorrhea; Humans; Infant; Infant, Newborn; Neisseria gonorrhoeae; Povidone-Iodine; Practice Guidelines as Topic; Pregnancy; Pregnancy Complications, Infectious

Topics: Adolescent; Adult; Female; Gonorrhea; Humans; Povidone; Povidone-Iodine; Prospective Studies; Sex Work; Vagina