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Alert Date: 
Thursday, March 21, 2019 - 4:00pm
Location: 
Canada

Dear Health Care Providers,

Please review the information below from the Ministry of Health and Long Term Care (MOHLTC) regarding an update for the ongoing national shortage of erythromycin ophthalmic ointment, indicated for the prophylaxis of ophthalmia neonatorum.

A limited supply has returned to the market with reported estimated end dates in March and April. The MOHLTC will keep monitoring the supply and will provide updates as they become available.

Hospitals are urged to conserve and prioritize access to the highest risk cases (i.e. high risk sexual behavior, partner with STI, is homeless/under housed, has new or multiple sexual partners or partner does, and/or no prenatal care).

The Provincial Council for Child and Maternal Health (PCMCH) with involvement from the MOHLTC, and London Health Sciences Centre have developed algorithms for screening and response to lab results in order to support local assessments and decision making.

The algorithms are attached to this update. They can also be downloaded from PCMCH’s website at the following link: http://www.pcmch.on.ca/erythromycin-ophthalmic-ointment/

It should be noted that PCMCH advises at this time that there is no recommended safe alternative medication to be used prophylactically for newborns instead of erythromycin. Therefore, it is recommended that the supply of erythromycin be monitored closely, and if adequate supplies are not available, administration be based on the attending health care professional’s assessment of the situation.

Additionally, in order to support newborn primary care, facilities should include a note in the newborn health record that is provided to parents indicating whether erythromycin ophthalmic ointment was administered. Parents and all neonatal healthcare providers should also be made aware of the symptoms of ophthalmia neonatorum and advised to monitor for these symptoms within the first four weeks of life and to seek medical treatment at any signs of infection.

The ministry also reminds all healthcare professionals that once the supply of erythromycin is returned to normal stock levels, routine administration of the ophthalmic prophylaxis to the eyes of newborns should continue as required under Regulation 557 Communicable Diseases – General under the Health Promotion and Protection Act.

Thank you for your help in this matter.

Sincerely,
Dr. Wajid Ahmed
Medical Officer of Health