This is a very informative article on erythromycin!  As a parent it is your right to accept or decline anything that is given or offered to your baby. 

 Is Erythromycin Eye Ointment Always Necessary for Newborns?

www.evidencebasedbirth.com

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By Rebecca Dekker, PhD, RN, APRN © 2012

What is the history of using eye ointment in newborns?

The use of erythromycin eye ointment in newborns has its roots in the late 1800s. During that time period, approximately 10% of newborns born in maternity hospitals across Europe developed ophthalmia neonatorum (ON). This is a type of pink eye that caused blindness in 3% of infants who were affected (Schaller and Klauss 2001). This means that during the late 1800s, before antibiotics were discovered, 0.3% of infants (3 out of 1,000) were blinded from ON.

In 1881, a physician named Carl Crede realized that infants were catching ON during vaginal delivery, and that the infections were caused by gonorrhea—a sexually transmitted infection. Dr. Crede found that by putting silver nitrate in the eyes of newborn babies, he could prevent ON. In fact, the number of newborn ON infections in Dr. Crede’s hospital went from 30-35 cases per year to 1 case in the first six months he started using silver nitrate.

Today, more than 130 years after Dr. Crede made his discovery, quite a few things have changed. First, the development of antibiotics has made it possible to treat an infant who contracts ON—thus making blindness highly unlikely. Also, silver nitrate is no longer used in most developed countries, because it is highly irritating to the eye and can cause severe pain, chemical pink eye, and temporary vision impairment. Silver nitrate is also not effective with infections caused by chlamydia, the most common cause of ON today. Furthermore, silver nitrate and tetracycline eye ointment (another antibiotic that has been used in the past to prevent ON) are no longer available in the U.S. For these reasons, 0.5% erythromycin ophthalmic ointment is used in the U.S. and Canada to prevent ON infection.

What causes ophthalmia neonatorum?

Pink eye, or conjunctivitis, can be caused by viruses (ex. Herpes), bacteria, chemicals, and blocked tear ducts. One type of pink eye called ophthalmia neonatorum (ON). ON is a conjunctivitis or pink eye that occurs during the first month of life and is contracted during birth. The two main causes of ON are chlamydia or gonorrhea, both of which are sexually transmitted infections (Ali, Khadije et al. 2007). For the rest of this article, whenever I say “ON,” I am referring to chlamydial or gonorrheal ON. Without treatment, ON can potentially lead to permanent eye damage or blindness. However, this is a treatable disease, and blindness can be avoided if oral or intravenous antibiotics are administered promptly after an infant develops ON (Darling and McDonald 2010).

The only way for a newborn to contract ON is if the mother is infected with chlamydia or gonorrhea. If the mother does not have chlamydia or gonorrhea, then the newborn cannot catch it. Also, if a baby is born by C-section and if the mom’s water never broke before surgery, then it is extremely unlikely that the baby could catch ON (Medves 2002).

How do you know if a mother is at risk for chlamydia or gonorrhea?

Anyone who is sexually active can contract chlamydia or gonorrhea. You can avoid both chlamydia and gonorrhea if you are in a long-term, mutually faithful relationship in which both partners have been tested and are uninfected. Your risk of contracting chlamydia or gonorrhea is higher if you are young (under the age of 25), if you have multiple sexual partners, or if you live in an area where there are high rates of infection. In the U.S., gonorrhea rates are lower now than they have been in the past, while chlamydia rates are rising (CDC, 2010). In Africa and in some developing countries rates of these infections are much higher.

Most people who have chlamydia or gonorrhea do not have any symptoms, so you can have an infection and not know it. Chlamydia and gonorrhea can cause serious health consequences, such as infertility, ectopic pregnancy, pelvic inflammatory disease and preterm birth. For these reasons, most women in developed countries are screened for chlamydia and gonorrhea (CDC, 2012).

Why is erythromycin used to prevent ON?

 

 

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