| dc.description.abstract | Aims: To investigate if a second drop of 2.5% povidoneiodine ophthalmic solution placed within the first postnatal day would achieve better prophylaxis against ophthalmia neonatorum than a single drop applied at birth.
Methods: A masked, prospective, controlled trial was conducted
over a 2 year period in a Kenyan hospital.
Randomisation was achieved by alternating weeks of one
or two eye drop application to both eyes. All 719 neonates
received one drop of the povidone-iodine solution to both
eyes at birth, while 317 received a second drop at hospital
discharge or 24 (SD 4) hours after delivery, whichever was
first. All infants developing conjunctivitis within a month after
birth underwent microbiological analysis using Gram and
Giemsa stains, direct fluorescent antibody assay for
Chlamydia trachomatis, and culture.
Results: Of the neonates receiving the one eye drop
application, 18.4% returned with a red eye with discharge,
4.0% had organisms found on the initial smear, and 8.2%
had a positive culture. The corresponding proportions for the
multidrop group were 24.3%, 4.7%, and 10.4%. Of those
returning with an inflamed eye, there were no cases of
Neisseria gonorrhoeae, 4.2% in the single dose group and
3.9% in the double dose group were positive for C
trachomatis, and 5.4% and 6.5% respectively for
Staphylococcus aureus. At discharge, the eyelid oedema
score of the double dose group was mildly greater than the
single dose group (1.4 (0.67) v 1.2 (0.73), p = 0.0002). There was no statistically significant difference between the
groups in any other category. Conclusion: There is no advantage to administering povidone- iodine prophylaxis against ophthalmia neonatorum twice in the first postnatal day over a single application at birth. | en |
