What is the recommended treatment for gonococcal conjunctivitis in neonates?

Gonococcal conjunctivitis in neonates is a serious condition that requires prompt and effective treatment to prevent complications such as corneal perforation and potential vision loss. The causative agent, Neisseria gonorrhoeae, is a highly virulent organism, and it is crucial to use systemic antibiotics that are effective against this pathogen.

The recommended treatment for gonococcal conjunctivitis in neonates involves the administration of intravenous (IV) or intramuscular (IM) third-generation cephalosporins, such as ceftriaxone. These antibiotics provide broad coverage against Neisseria gonorrhoeae, ensuring adequate tissue penetration and effective resolution of the infection. Systemic administration allows for higher serum and tissue levels of the antibiotic, which is essential for combating such a potent bacterium.

Topical antibiotics alone are insufficient because they do not achieve therapeutic levels deep within the conjunctival tissues where the infection resides. Oral azithromycin, while effective for certain infections, is not the first line for addressing gonococcal infections in neonates due to its limited efficacy against Neisseria gonorrhoeae compared to third-generation cephalosporins. Surgical intervention is not indicated for managing this infection unless there are complications such as