Comparison of Povidone Iodine and Erythromycin with control cases in prevention of Ophthalmia Neonatarum

Abstract

Neonatal conjunctivitis (ophthalmia neona-tarum) continues to involve many neonates in areas with no eye prophylaxis. Povidone iodine solution is an effective antimicrobial agent with broad antibacterial and antiviral activity and it is less expensive and less toxic than the other agents. It seems to be a good alternative for routine eye prophylaxis, especially in developing countries. In a prophylaxis. Especially in developing countries. In a prospective trial, 360 infants born over a period of ten month in years 2000-2001 were divided in three groups randomly. Each infant received a 2.5% povidone iodine solution, or 0.5% erythromycin ointment or no prophylaxis as a control group. There were 17.5% , 10% and 5.8% of infectious conjunctivitis in control, erthromycin and povidone iodine groups respectively. In spite of reduction of clinical and infectious conjunctivitis in erythromycin compared to control group and in povidone iodine compared to erythromycin group, the only and most significant difference was between povidone iodine and control groups (P=0.0036 for clinical conjunctivitis and P=0.0089 for infectious ones). The most common organisms were gram-negative bacilli and staphylococcus aureus in all groups and chlamydia trachomatis was responsible for 9.5% of infectious conjunctivitis (4 th common agent) with an incidence of 1.7% in control group. As well, birth in unhygienic environment (mother defecation) and meconium staining of amniotic fluid were significantly associated with higher conjunctivitis rate but vaginal infection of mother had no such effect. We found that there is a high incidence of conjunctivitis with no eye prophylaxis.Povidone iodine is more effective, easiter to use and has no toxic reaction. So it seems that 2.5% povidone iodine solution is a good alternative for routine eye prophylaxis