Published: 2021-09-23

Proportion of ophthalmia neonatorum following prophylaxis with azithromycin eye ointment in newborns at a tertiary care centre in Central Kerala

Najeeba Chamban Mammooty, Madhu George, Jino Joseph, Abdul Tawab


Background: The objective was to evaluate the proportion of ophthalmia neonatorum among 425 hospital born newborns who had received antibiotic eye prophylaxis within one hour of birth at a tertiary care centre in Central Kerala and to detect their causative organisms.

Methods: The study design was an observational study done for a period of 10 months. A total of 425 term well newborn babies were included in the study. At delivery after the normal routine newborn care, babies were received azithromycin 1% eye ointment as prophylaxis for neonatal conjunctivitis in both eyes within one hour of birth. Babies were observed routinely during every vital monitoring for developing signs of neonatal conjunctivitis for the first 72 hours of life at hospital. During outpatient follow ups, 7 to 14 days and 14 to 28 days, these babies were examined for the presence of neonatal conjunctivitis. Babies having neonatal conjunctivitis were treated empirically with the same topical 1% azithromycin eye ointment after taking eye swab for culture and sensitivity in both eyes. The treatment has been modified based on the culture reports. Proportions were compared using Chi-square test with significance at p<0.05.

Results: A total 15 (3.5%) of the 425 babies developed ophthalmia neonatorum. The most common isolate was Staphylococcus aureus which was 4 (26.7%) of all positive cultures followed by Escherichia coli 13.3%, Klebsiella pneumoniae 6.7%, Serracia marcescens 6.7%. None of the risk factors were found to be having association with conjunctivitis.

Conclusions: This study concludes that a high proportion of neonatal conjunctivitis present despite eye antibiotic prophylaxis, though a greater reduction in cases has been shown when compared with no prophylaxis at our centre during the previous year. S. aureus was the most common causative organism isolated. 


Ophthalmia neonatorum, Antibiotic eye prophylaxis, Newborn eyes

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Fransen L, Klauss V. Neonatal ophthalmia in the developing world. Int Ophthalmol. 1988;11(3):189-96.

Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G. Neonatal conjunctivitis-a review. Malays Fam Physician Off J Acad Fam Physicians Malays. 2008;3(2):77-81.

Wadhwani M, D’souza P, Jain R, Dutta R, Saili A, Singh A. Conjunctivitis in the newborn-a comparative study. Indian J Pathol Microbiol. 2011;54(2):254.

Isenberg SJ, Apt L, Wood M. The influence of perinatal infective factors on ophthalmia neonatorum. J Pediatr Ophthalmol Strabismus. 1996;33(3):185-8.

Lambert SR, Lyons CJ. Taylor and Hoyt’s Pediatric Ophthalmology and Strabismus E-Book. 5th ed. Philadelphia: Elsevier Health Sciences; 2016: 1181.

Amini E, Ghasemi M, Daneshjou K. A five-year study in Iran of ophthalmia neonatorum: prevalence and etiology. Med Sci Monit Int Med J Exp Clin Res. 2008;14(2):90-6.

Zikic A, Schünemann H, Wi T, Lincetto O, Broutet N, Santesso N. Treatment of neonatal chlamydial conjunctivitis: a systematic review and meta-analysis. J Pediatr Infect Dis Soc. 2018;7(3):107-15.

Franz CKS. The prevention of inflammation of the eyes in newborns (ophthalmoblennorrhoea neonatorum) the most common and most important cause of blindness. Berlin: August Hirschwald; 1884.

Ali Z, Khadije D, Elahe A, Mohammad M, Fateme Z, Narges Z. Prophylaxis of ophthalmia neonatorum comparison of betadine, erythromycin and no prophylaxis. J Trop Pediatr. 2007;53(6):388-92.

Gul SS, Jamal M, Khan N. Ophthalmia neonatorum. J Coll Physicians Surg-Pak JCPSP. 2010;20(9):595-8.

Verma M, Chhatwal J, Varughese PV. Neonatal conjunctivitis: a profile. Indian Pediatr. 1994;31(11):1357-61.

Chang K, Cheng VYW, Kwong NS. Neonatal haemorrhagic conjunctivitis: a specific sign of chlamydial infection. Hong Kong Med J. 2006;12(1):27-32.

DiBartolomeo S, Higa M, Janer M, Pennisi A, Balbin G, Priore G. Neonatal conjunctivitis in a hospital at Gran Buenos Aires. Last 5 years up-date. Rev Argent Microbiol. 2005;37(3):139-41.

A controlled trial of povidone-iodine as prophylaxis against ophthalmia neonatorum. Indian J Pediatr. 1995 Nov 1;62(6):701.

Prentice MJ, Hutchinson GR, Taylor-Robinsin D. A microbiological study of neonatal conjunctivae and conjunctivitis. Br J Ophthalmol. 1977;61(9):601-7.

Mohile M, Deorari AK, Satpathy G, Sharma A, Singh M. Microbiological study of neonatal conjunctivitis with special reference to chlamydia trachomatis. Indian J Ophthalmol. 2002;50(4):295.