Zuppa Antonio Alberto, D'Andrea Vito, Catenazzi Piero, Scorrano Antonio, Romagnoli Costantino
Department of Pediatrics, Catholic University of the Sacred Heart, Division of Neonatology, Rome, Italy.
J Matern Fetal Neonatal Med. 2011 Jun;24(6):769-73. doi: 10.3109/14767058.2010.531326.
Conjunctivitis during neonatal period occurs in 1-12% of all babies. Ophthalmia neonatorum is an acute muco-purulent conjunctivitis occurring in the first month of birth. It is essentially an infection acquired during vaginal delivery. The most frequent infectious agents involved in ophthalmia neonatorum are Chlamydia trachomatis and Neisseria gonorrhoeae.
Topical ocular prophylaxis must be instituted early after birth. Recommended prophylactic regimen are: 1% nitrate solution; 1% tetracycline solution; 1% erythromycin solution; 2.5% povidone-iodine solution; and fusidic acid.
Evidence suggests better outcomes using 1% tetracycline solutions even if there is the risk of selecting drug resistant bacteria. However, even the widespread used nitrate solution can cause a chemical conjunctivitis, arguing against its widespread use.
Fusidic acid is a relatively new promising therapy even if there are still few data about its use. None of the used regimens has the optimal risk-benefit profile to suggest a widespread use.
所有新生儿中1% - 12%会在新生儿期发生结膜炎。新生儿眼炎是一种在出生后第一个月出现的急性黏液脓性结膜炎。它本质上是在阴道分娩过程中获得的感染。新生儿眼炎最常见的感染病原体是沙眼衣原体和淋病奈瑟菌。
必须在出生后尽早进行局部眼部预防。推荐的预防方案有：1%硝酸银溶液；1%四环素溶液；1%红霉素溶液；2.5%聚维酮碘溶液；以及夫西地酸。
有证据表明，即使存在选择耐药菌的风险，使用1%四环素溶液的效果更好。然而，即使广泛使用的硝酸银溶液也会引起化学性结膜炎，这反对其广泛使用。
夫西地酸是一种相对较新且有前景的治疗方法，尽管关于其使用的数据仍然很少。所使用的任何方案都没有最佳的风险效益比来支持广泛使用。
