Prophylaxis of ophthalmia neonatorum [Prophylaxe der ophthalmia neonatorum]

Conjunctivitis of the newborn is defined as any conjunctivitis that occurs within the first 4 weeks of life. Neonatal conjunctivitis is caused by a bacterial, viral or chlamydial infection, or by a toxic response to topically applied chemicals. The causative agents that most frequently responsible for ophthalmia neonatorum in the 'first' world are Chlamydia trachomatis and Staphylococci. Gonococcal ophthalmia neonatorum still remains a problem although a rarer one - affecting approximately 0.04% of neonates in industrialized countries. Because of the potentially high risk of blindness with this agent, any type of prophylaxis has to cover this virulent germ. The usage of silber nitrate at a concentration of 1% - as it has been introduced by Crede in 1881 - has been criticized for the frequent chemical conjunctivitis and its incomplete protection against chlamidia. To avoid these problems other antiseptics - e.g. povidone-iodine - or such as tetracycline and erythromycine, have been substituted for silver nitrate. According to the results of the recently held consensus-meeting povidone- iodine 2.5% is present to be considered the substance of choice for the prophylaxis of newborns against ophthalmia neonatorum and should be used on wards for the newborn.