Ophthalmia neonatorum (newborn conjunctivitis)

Not applicable - a disease of the first month of life - Single dose

25-50 mg/kg/dose [child max 125 mg]

(25-50 mg/kg as a single intramuscular dose, never more than 125 mg.)

WATCH group - carries resistance cost. Egyptian EML 2025.

StatPearls: Ophthalmia Neonatorum (NCBI Bookshelf NBK551572)

For gonococcal disease, which is the one that blinds. Purulent discharge with marked lid swelling in the first five days is gonococcal until proved otherwise, and it does not wait for a swab result.

Not applicable - a disease of the first month of life - Single dose, repeated after one week

20 mg/kg/dose

(20 mg/kg by mouth as a single dose, repeated once a week later. Erythromycin 50 mg/kg/day in 4 divided doses for 14 days is the alternative.)

WATCH group - carries resistance cost. Egyptian EML 2025.

StatPearls: Ophthalmia Neonatorum (NCBI Bookshelf NBK551572)

For chlamydial disease, the commoner cause and the later one - typically the second week, with less dramatic swelling. Ceftriaxone does not cover chlamydia at all, so a gonococcal dose alone leaves it untreated.

Ophthalmia Neonatorum - disease-level clinical article (ophthalmia-neonatorum-clinical.txt)

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

IV: 10 mg/kg/dose every 8 hours. x 14 to 21 days

20 mg/kg/dose

(Neonates and children ≤3 months of age: 20 mg/kg every 8 hours given for 14 days for infections of skin, eyes, or mouth or 21 days for disseminated or CNS infections.)

This mg/kg figure applies up to 6 kg only - above that, dose on specialist advice

Egyptian National Drug Formulary - Antimicrobial 2023

Systemic antiviral therapy for HSV conjunctivitis and ocular infection in newborns.

Irrigate the eye with sterile isotonic saline, repeated frequently until the discharge stops - Until the discharge settles

Frequent sterile saline irrigation, daily at least, until the eye stops discharging.

No labelled dose - a procedure, not a medicine

Washes away the purulent load while the antibiotic works. It treats nothing on its own.

0.5% ointment applied to both eyes within the first hour after birth

Applied to both eyes within the first hour after birth.

Ophthalmia neonatorum (newborn conjunctivitis) - disease-level clinical article (ophthalmia-neonatorum-clinical.txt)

Universal ocular prophylaxis at birth to prevent gonococcal and chlamydial ophthalmia neonatorum.

Not applicable - a disease of the first month of life

50 mg/kg/dose

(ENDF, general neonatal dosage: 0-1 week, 50 mg/kg IV every 12 hours; 1-4 weeks, 50 mg/kg IV every 8 hours.)

This mg/kg figure applies up to 5 kg only - above that, dose on specialist advice

WATCH group - carries resistance cost. Egyptian EML 2025.

Egyptian National Drug Formulary - Antimicrobial 2023 (cefotaxime monograph, neonatal dosage)

Ceftriaxone is the card's gonococcal agent and the disease article names cefotaxime 50 mg/kg IM or IV as its substitute when ceftriaxone is not available - a real situation in Egyptian practice. The ENDF's neonatal cefotaxime figure is the same 50 mg/kg at the same routes.

1 g orally as a single dose - given to the MOTHER and to her sexual partner, not to the baby - Single dose

NOT a paediatric row and not the baby's dose. The baby's azithromycin is 20 mg/kg as a single dose, repeated once a week later - see the Chlamydial row on this card.

WATCH group - carries resistance cost. Egyptian EML 2025.

Ophthalmia neonatorum - disease-level clinical article (ophthalmia-neonatorum-full.txt), Maternal and partner therapy, corroborated by Egyptian National Drug Formulary - Antimicrobial 2023 (azithromycin monograph, Dosage Regimen, Sexually transmitted infections)

The card treated the baby and left the source of the infection untreated. One sentence in the card's own article carries both claims: treating the mother at the same time - azithromycin 1 g by mouth - along with her sexual partners, is essential if reinfection is to be prevented. The Egyptian formulary doses the same regimen for the same purpose, giving 1 g orally as a single dose for a sexually transmitted infection, alone or in combination, under an indication that names the treatment of urethritis and of cervicitis. The information was already on the card as a bare caution; it is now a row with a document behind it, under its own heading so it cannot be mistaken for the baby's dose.