Ruiyang Sun, Xiu Zhu, Ting Zhang, Hong Lu

A review of clinical practice guidelines for preventing chlamydial and gonococcal ophthalmia neonatorum

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Abstract Objective: The objective of this study is to evaluate and analyze clinical practice guidelines pertinent to the prevention of ophthalmia neonatorum in newborns after delivery. The aim is to offer guidance to medical and nursing staff regarding newborn eye care within the clinical context. Methods: WHO, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Queensland Clinical Guideline, Joanna Briggs Institute, Canada Registered Nurses’ Association of Ontario, New Zealand Guidelines Group, and Chinese Medlive, professional societies focusing on newborn care, and bibliographic databases, such as PubMed, Embase, Web of Science, CNKI, WanFang Database, VIP, and SinoMed, were systematically searched. The International Guidelines Evaluation Screening Tool and Appraising Guidelines Research and Evaluation II were utilized to assess the quality of the guidelines. Content analysis methodology was used for summarization, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was applied to determine the quality of evidence and the strength of recommendations. Results: A total of 8 guidelines pertaining to neonatal ophthalmia were included in the analysis. Among them, guidelines from the National Institute for Health and Clinical Excellence and WHO obtained higher scores (≥80%). Seven guidelines recommended universal topical ocular prophylaxis. In addition, 2 guidelines recommended prescreening and pretreatment of pregnant women at risk of exposure to chlamydia and gonococcus. In total, 17 recommendations were summarized. While the quality of specific evidence ranged from “very low” to “low,” the majority (12/17) of the recommendation strengths were classified as “strong.” Conclusions: In the clinical context, both universal topical ocular prophylaxis for neonates and screening and treatment of pregnant women and their partners for sexually transmitted diseases are recommended.

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