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Regional care model enables rapid response to adverse drug events

Journal of Perinatology volume 30, page 300 (2010)Cite this article

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The recent shortage of erythromycin ophthalmic ointment has compelled pediatricians to choose alternative therapies for ophthalmia neonatorum prophylaxis. The Cincinnati Children's Division of Neonatology, which staffs nine regional nurseries, recommended substitution of gentamicin ophthalmic ointment (0.3%) after supplies of erythromycin ointment were exhausted. This decision was based on reports of efficacy,1, 2 cost analysis and the recommendations of the Centers for Disease Control.3

Erythromycin ointment contains only mineral oil and petroleum jelly. Gentamicin ointment contains the preservatives methylparaben and propylparaben, which are esters of para-hydroxybenzoic acid. Although there are no published reports of skin reaction to gentamicin ophthalmic ointment, use for ophthalmia neonatorum prophylaxis is presumably novel. Within 48 h of identifying the first adverse reaction, we substituted tobramycin ophthalmic solution, which provides the same bacterial coverage and cost savings. This preparation contains the preservative benzalkonium chloride, a quaternary ammonium cationic surfactant, and has not generated any periorbital skin irritation to date.

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References

  1. Nsanze H, Dawodu A, Usmani A, Sabarinathan K, Varady E . Ophthalmia neonatorum in the United Arab Emirates. Ann Trop Paediatr 1996; 16 (1): 27–32.

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  2. Jain S, Kulkarni M, Banker D . Antibiotic susceptibility pattern of gonococcal isolates. Indian J Med Sci 1994; 48 (10): 233–236.

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  3. CDC. Guidance on shortage of erythromycin ophthalmic ointment. http://www.cdc.gov/STD/treatment/2006/erythromycinOintmentShortage.htm(accessed September 2009).

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  1. Division of Neonatology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

    S L Wexelblatt, J M Greenberg & A T Nathan

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  1. S L Wexelblatt
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  2. J M Greenberg
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  3. A T Nathan
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Correspondence to A T Nathan.

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Wexelblatt, S., Greenberg, J. & Nathan, A. Regional care model enables rapid response to adverse drug events. J Perinatol 30, 300 (2010). https://doi.org/10.1038/jp.2010.17

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