1. Crede’s prophaylaxis is the instilling of ordered ophthalmic ointment into the newborn’s eyes to avoid damage and blindness due to conjunctivitis brought about by Neisseria gonorrhea.

2.  ACTION: These antibiotic ointments are bacteriostatic and bactericidal. They provide prophylaxis against Neisseria gonorrhoeae and chlamydia trachamatis.  INDICATION: These medications are applied to prevent ophthalmia neonatorum in newborns of mothers who are infected of gonorrhea and conjunctivitis in newborn of mothers infected with chlamydia.

3.  NEONATAL DOSAGE: Apply 1 to 2 cm ribbon of ointment to the lower conjuctival sac of eye; also may be used in drop form.  ADVERSE REACTION: may cause chemical conjunctivitis that lasts 24 to 48 hrs; vision maybe blurred temporarily.

4.  Sterile gauze  Sterile cotton ball  Sterile normal saline solution  Prescribed eye antibiotic ointment

5.  Prepare all materials needed ( to conserve time and energy)  Wash hands thoroughly ( to prevent spread of infection)  Wipe eyelid of the newborn with a sterile cotton ball saturated with sterile normal saline solution, from the inner canthus to the outer canthus of the eye.

6.  Retract the lower eyelid with your thumb ( to reveal the conjunctiva, because the ointment is supposed to be placed on the conjuctiva sac and not on the eyeball.)

7.  Instill a liberal amount of the doctor ordered ophthalmic ointment in the lower conjuctival sac starting from the inner to the outer canthus of the eye. The tip of the tube should not touch the eye or eyelid ( to prevent injury).

8.  Wipe off excess medication with a sterile gauze ( as this may irritate the skin near the eyes)  Repeat procedure with the other eye.

9. NURSING CONSIDERATIONS:  Administer within 1 to 2 hours of birth.  Wear gloves.  Cleanse eyes if necessary before administration.  Open eyes by putting a thumb and finger at the corner of each lid and gently pressing on the periorbital ridges.

10. NURSING CONSIDERATIONS:  Squeeze the tube and spread the oitnment from the inner canthus of the eye to the outer canthus.  Do not touch the tube to the eye.  After 1 minute excess ointment may be wiped off.  Observe eyes for irritation.

11. NURSING CONSIDERATIONS:  Explain treatment to parents.  Eye prophylaxis for ophthalmia neonatorum is required by law in all states of the United States.

12.  It is part of the routine care of the newborn to give prophylactic eye treatment against gonorrhea conjunctivitis or opthalmia neonatorum.  Neisseria gonorrhea, the causative agent, may be passed on the fetus from the vaginal canal during delivery.  This practice was introduced by Crede, a German gynecologist in1884. Silver nitrate, erythromycin and tetracycline ophthalmic ointments are the drugs used for this purpose.