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Invited Commentary
December 17, 2020

Using Adult Drug Efficacy Data to Aid in Interpretation of Underpowered Pediatric Studies

Author Affiliations
  • 1Department of Ophthalmology, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis
JAMA Ophthalmol. Published online December 17, 2020. doi:10.1001/jamaophthalmol.2020.5557

Ophthalmia neonatorum (ON) is an infectious condition of the ocular conjunctiva that occurs in infants younger than 1 month. Infants are thought to have increased levels of exposure to pathogens during the birthing process, and it is believed that many bacterial or viral infections are passed from mother to infant in the birth canal. In addition, neonates are believed to be more susceptible to acquiring infections owing to reduced immunity.

When treating ON, it is important to consider both the most common bacterial pathogens and the pathogens capable of causing the worst complications. Although uncommon, infections of Neisseria gonorrhoeae have been known to cause corneal perforation and meningitis, whereas Chlamydia trachomatis infections have led to permanent vision loss and life-threatening pneumonia. It is also prudent to consider the safety profile of the medication used for the treatment of ON. Silver nitrate was very effective at reducing ON, but its use was discontinued because of toxic effects. Ideally, antibiotic coverage should be well tolerated, broad spectrum, and cover the worst offenders.

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