Prophylactic antibiotics placed on the conjunctiva of newborns can cause a chemical conjunctivitis.
Clinical features:
(1) history of instilling antibiotics into the eyes of a newborn after birth
(2) mild, purulent conjunctivitis during the first 24 hours after delivery
(3) resolution within 48 hours
(4) negative Gram stain of conjunctival material
The reaction is more common with silver nitrate than other antibiotics (erythromycin, tetracycline).
The conjunctivitis is self-limited and does not require treatment.