Clinical significance of Crede's prophylaxis in germany at present.
Clinical significance of Crede's prophylaxis in germany at present.
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DOI：
10.1155/s1064744993000080
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发表时间：
1993-01-01
影响因子：
--
通讯作者：
Hoyme, U B
中科院分区：
文献类型：
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作者：
Hoyme, U B
硝酸银用于预防淋球菌性眼炎是预防医学的里程碑之一。然而，在我们这个时代，越来越有必要从人权和医学的角度来审查Crede的预防措施。对德国大学医院妇产科主任进行了询问，以了解他们的政策和经验。28个咨询机构中有22个提供了数据，代表在平均5.5年的时间里每年接生31 700次。16家（73%）报告医院使用了眼部预防（14家使用1%银，2家使用庆大霉素）。5-10%的新生儿发生了非特异性结膜反应，但未见重大副作用。非淋菌性结膜炎的发病率不到0.1%;然而，没有预防政策的机构报告了高达5%的新生儿结膜炎发病率，主要是由于金黄色葡萄球菌，以及两名新生儿的淋病奈瑟菌。应用银被认为是必要的预防措施，如果正确使用，则是安全的。然而，主要的努力应该是针对它的替代抗菌物质以及对衣原体筛查和治疗怀孕。
The introduction of silver nitrate for prophylaxis of gonococcal ophthalmia neonatorum is one of the milestones of preventive medicine. However, in our time an increasing necessity to review Crede's prophylaxis from both a human rights and a medical standpoint is required. The chairmen of the obstetrics and gynecology departments of the German university hospitals were questioned to learn about their policy and experience. Data were provided by 22 of 28 consulted institutions, representing 31,700 annual deliveries seen over a mean period of 5.5 years. Ocular prophylaxis was in use in 16 (73%) of the reporting hospitals (1% silver nitrate in 14 and gentamicin in 2). A nonspecific conjunctival reaction occurred in 5-10% of the newborns, but no major side effects were seen. Non-gonococcal ophthalmia neonatorum was observed in less than 0.1%; however, institutions without a preventive policy reported up to a 5% incidence of neonatal conjunctivitis, mostly due to Staphylococcus aureus, as well as Neisseria gonorrhoeae in two newborns. Application of silver nitrate is considered a necessary prophylactic measure and safe if it is properly administered. However, major efforts should be directed toward its replacement by alternative antiseptic substances as well as toward chlamydial screening and therapy in pregnancy.