Erythromycin (0.5%) Ophthalmic Ointment Shortage

Erythromycin 0.5% ophthalmic ointment is the only recommended regimen to prevent ophthalmia neonatorum caused by N. gonorrhoeae. If erythromycin ointment is unavailable, infants at risk for exposure to N. gonorrhoeae, especially those born to a mother at risk for gonococcal infection or with no prenatal care, can be administered ceftriaxone 25–50 mg/kg body weight IV or IM, not to exceed 250 mg in a single dose.

Other topical medications are not recommended: tetracycline ophthalmic ointment and silver nitrate are no longer available in the United States; gentamicin was associated with chemical conjunctivitis during the last erythromycin shortage; and povidone-iodine has limited data on its benefits and harms.

Most importantly, gonorrhea ocular prophylaxis of newborns is mandated by law in most states and is considered standard neonatal care.  This prophylaxis is consistent with USPSTF recommendations.

It is also important to remember that prenatal screening is the best method for preventing gonococcal ophthalmia neonatorum among newborns!  All pregnant women < 25 years of age and women > 25 at increased risk should be screened for N. gonorrhoeae at the first prenatal care visit and again at the third trimester if risk continues during pregnancy.  Also, all females treated for gonorrhea should be retested 3 months following treatment.

Additional treatment guidance is available in the CDC’s STI Treatment Guidelines, 2021.

Please notify your local health department of any challenges in procuring product. Current information regarding the availability of erythromycin (0.5%) ophthalmic ointment is available at the FDA Drug Shortage Website.