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Newborn Eye Prophylaxis: A Review of Clinical Effectiveness and Guidelines

Last updated: May 3, 2016
Project Number: RC0775-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of erythromycin for newborn eye prophylaxis?
  2. What are the evidence-based guidelines for newborn eye prophylaxis?
  3. What are the evidence-based guidelines for screening women for gonorrhea and chlamydia in pregnancy?

Key Message

Results from one SR of low quality evidence suggested that there is no statistically significant advantage to using erythromycin over other prophylactic agents for the prevention of gonococcal ON, though erythromycin may be more effective than silver nitrate for the prevention of chlamydial ON. There was limited available evidence comparing prophylactic erythromycin to no treatment. Three evidence-based guidelines were identified that present contrasting recommendations; two guidelines recommend universal newborn eye prophylaxis, while one guideline does not recommend routine prophylaxis for newborns who are not at increased risk or showing signs of infection. Five evidence-based guidelines were identified that provide recommendations regarding screening pregnant women for chlamydia and gonorrhea. Routine screening of pregnant women is not recommended in one guideline, and three guidelines recommend screening when women are at high risk of infection or belong to a high prevalence age group. One guideline recommends the use of nucleic acid amplification tests to screen any asymptomatic individual for gonorrhea, but does not address timing or frequency of screening. The limited quantity and quality of evidence included in the single SR and supporting the guidelines regarding newborn eye prophylaxis and maternal screening for gonorrhea and chlamydia reduced confidence in the findings.