A 3-day-old neonate develops bilateral purulent conjunctival discharge. Gram stain of the exudate shows intracellular Gram-negative diplococci. What is the immediate treatment of choice?
- A Topical tetracycline ointment alone
- B Single dose ceftriaxone 25 to 50 mg/kg IV or IM plus saline irrigation ✓
- C Oral erythromycin for 14 days alone
- D Topical gentamicin drops every 4 hours for 7 days
Correct answer: B. Single dose ceftriaxone 25 to 50 mg/kg IV or IM plus saline irrigation
Explanation
Gonococcal ophthalmia neonatorum is a sight-threatening emergency requiring systemic therapy: a single dose of ceftriaxone 25 to 50 mg/kg IV or IM, together with frequent saline irrigation of the eyes. Topical therapy alone is insufficient because corneal perforation can occur rapidly without systemic coverage.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.