Erythromycin Eye Ointment Shortage and prevention of neonatal eye infections with GC and chlamydia
From Megan Davies, MD, State Epidemiologist:
The recommended prophylaxis for ophthalmia neonatorum (ON), erythromycin (0.5%) ophthalmic ointment, has been identified as being in short supply by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA).
To prevent gonococcal ON, a prophylactic agent should be instilled into the eyes of all newborn infants and is required by North Carolina law. Currently, erythromycin ophthalmic ointment is the only recommended prophylactic agent available in the US. The primary recommendation for prophylaxis is to prevent gonococcal ophthalmia. Prophylaxis is also intended to prevent Chlamydia infection. Consideration for the variable efficacy of alternative agents in preventing chlamydial ophthalmia must be taken into consideration for follow-up.
CDC guidance addressing this shortage is available at http://www.cdc.gov/std/treatment/2006/erythromycinOintmentShortage.htm. There are links to this guidance and the Dear Colleague letter sent out by CDC on the CDC STD home page http://www.cdc.gov/std/ and on the CDC Treatment home page, http://www.cdc.gov/std/treatment/.
If one of the alternative treatments is employed due to erythromycin ophthalmic ointment shortage, NC DPH strongly encourages testing the mother for Chlamydia and gonorrhea at delivery, even if she has already been screened during the third trimester. Additionally, careful monitoring of infants for the development of symptoms should be performed after delivery and at the first postnatal office visit 48-72 hours post discharge from the hospital.