As far as I am aware eye prophylaxis has never been routine in Australia.
At risk of stepping on a political chestnut, perhaps this is because
Medicare and the Pharmaceutical Benefits Scheme (I think this might be what
you guys call a "one-payer medical provider") are unwilling to fund blanket
pharmaceutical intervention in order to prevent a relatively small number of
cases of gonorrhoea related conjunctivitis.  The cost is too high. (All
inpatient pharmaceuticals are provided at no cost to public in-patients who
are also treated at no cost to themselves.)  Certainly mothers are screened
for risk factors associated with STIs (by midwives at booking in visit -
there are screeds of personal questions to answer) and offered
testing/treatment.
Cheers
Nina Berry
Australia

-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Jeanette Panchula
Sent: Saturday, November 08, 2008 1:59 AM
To: [log in to unmask]
Subject: Delaying eye prophylaxis

Gloria from Vancouver, BC said:

 

"It's interesting to note that this is a N. American obsession--putting
antibiotics in baby's eyes.  It is not done in England or Australia and
midwives in those countries are mystified by why N. Americans do this
routinely. "

 

I totally agree about in the fact that in some cases this is unnecessary
treatment - and it was easy for our son and daughter-in-law to refuse it,
but they were at a university hospital, are white and both are very well
educated, married and had had a monogamous relationship since their last
test for Sexually Transmitted Infections (STI).  In order to make changes
for all, it is necessary to change the protocol.  

 

The research that drives having this treatment as a standard of care is the
extensive amount of STI that are in our population - many which never get
tested or treated for STIs.  Research proved that utilizing this medication
helps prevent blindness due to exposure to gonorrhea - however, the research
was not clear on how long they could wait to be effective.  I have  to admit
that wanting to avoid unnecessary blindness is a very real reason for
utilizing the treatment - so I believe that  we need to learn is how long it
is safe to wait.

 

So can our friends in Canada, England and Australia who are already NOT
doing this treatment report on outcomes and help us to change the protocols?
(I also would HIGHLY recommend research to see if utilizing colostrum for
the newborns' eyes might not be an effective way to avoid using
antibiotics.)

 

I was also wondering if there is a "fast test" available like there is now
for HIV so that physicians could order it and avoid introducing unnecessary
antibiotics into infants?  

 

Jeanette Panchula, BSW, RN, PHN, IBCLC

California, USA

 

 


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