New Guidelines on Syphilis Testing in Pregnancy
The American College of Obstetricians and Gynecologists released new guidelines recommending that all pregnant people be screened for syphilis three times during pregnancy.
Most infants born in the U.S. are given an antibiotic eye ointment soon after delivery. This prevents a potentially serious eye infection that can be caused by chlamydia, gonorrhea, or other bacteria transmitted from parent-to-infant during birth.
Unfortunately, there is currently a shortage of erythromycin 0.5% ophthalmic ointment, which is the only regimen recommended for this use. With no end of the shortage in sight, the Centers for Disease Control and Prevention (CDC) recently released recommendations for health care providers and hospitals that are unable to get this medication.
These alternatives include another ointment that could be used and treating infants who may have been exposed to chlamydia and gonorrhea during birth, but the agency stresses the importance of pre-natal STI testing for pregnant people. This is the best way to protect both them and their infants from potential long-term consequences.
Infants exposed to bacteria like chlamydia and gonorrhea during birth can get ophthalmia neonatorum or neonatal conjunctivitis. This can cause red, swollen, and goopy eyes. If not treated, it can lead to inflammation of the iris (the colored part of the eyes), a scar or hole in the cornea, or blindness.
Treating all infants as a precaution is important. Without it, an infant born to a mother who has gonorrhea, for example, has a 30% to 50% chance of getting infected.
The shortage of erythromycin eye ointment has been going on since 2022, because multiple pharmaceutical companies have stopped making it or decreased their production. To help alleviate the shortage, the FDA has temporarily approved a similar formula manufactured by a Canadian company for sale in the United States.
The CDC says that any provider who has access to erythromycin ophthalmic ointment (0.5%) should continue to use it. It then offers three alternative prevention options for those who can’t find it.
With options two and three, babies would be treated with an injection of antibiotics (either ceftriaxone or cefotaxime).
It’s important that providers understand these alternatives, but the CDC stresses that the best way to prevent chlamydia and gonorrhea infections in newborns is to screen all pregnant people for these STIs early in the pregnancy and again in later months. Anyone who tests positive can be treated before they give birth to avoid the risk of parent-to-child transmission.
The American College of Obstetricians and Gynecologists released new guidelines recommending that all pregnant people be screened for syphilis three times during pregnancy.
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As rates of congenital syphilis skyrocket, a severe shortage of the only antibiotic approved to treat syphilis in pregnant women is delaying care for pregnant patients.
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Treating syphilis during pregnancy can help both mother and child, but there is a shortage of Bicillin-L-A, the only antibiotic approved for this population.
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