Variability in the Evaluation and Treatment of Healthy Neonates With Uncomplicated Conjunctivitis
Year: 2024
Type: article
Study design: Observational Study
Abstract: Purpose To explore the current state of diagnosis and management of neonatal conjunctivitis. Methods Cosmos, an EHR-based, de-identified data set including more than 200 million patients, was used for this study. Neonates born between January 1, 2016 and December 31, 2022, discharged from the hospital by day 3 of life, and with an ambulatory visit within the first 4 weeks of life associated with a new diagnosis of neonatal conjunctivitis (SNOMED) or conjunctivitis (ICD-10 H10.*) were included. Cosmos slicer/dicer software was used to extract demographic, diagnostic, etiologic, and therapeutic data. Results A total of 1,870 of 7,325,276 (0.0255%) neonates with a hospital stay of 3 days or less met criteria for inclusion: 96.5% were from the United States, 16.2% were admitted to the hospital, and bacterial cultures were obtained from 21.3%. Congenital lacrimal duct stenosis was causative in 2.7% of patients. Important infectious agents included staphylococcal, streptococcal, or enterococcal species (2.5%), Neisseria gonorrhoeae (1.6%), and Chlamydia trachomatis (0.6%). No herpesviral or Pseudomonas infections were identified. Antimicrobial agents were prescribed to 93.7% of patients and given ophthalmically (79.5%), orally (11.4%), and parenterally (7.7%). Conclusions The evaluation and management of neonatal conjunctivitis within United States ambulatory settings are highly variable. Diagnostic studies are underused, resulting in limited etiologic data and a lack of susceptibility-guided treatment. [ J Pediatr Ophthalmol Strabismus . 2025;62(2):143–149.]
Authors: Camden Nelson, Bailee J. Deshler, Brittany Bernstein, Stephen Aronoff
Institutions: University of Pennsylvania, Temple University
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4405912865