Shortage of erythromycin ophthalmic ointment

Advisory Alert

March 25, 2019

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To community health care providers:

Re: shortage of erythromycin ophthalmic ointment

The purpose of this Advisory Alert is to provide you with an update regarding the ongoing national shortage of erythromycin ophthalmic ointment, indicated for the prophylaxis of ophthalmia neonatorum. We are also sharing algorithms that can be used for screening purposes and to respond to lab results.

Screening Algorithm (PDF, 526 KB)

Response to Lab Results Algorithm (PDF, 522 KB)

The Ministry of Health and Long-Term Care (MOHLTC) confirmed there was limited supply of the ointment through February and March, and has advised that the shortage could potentially end in March or April. However, based on this ongoing shortage, hospitals are urged to continue to conserve and prioritize access to the highest risk patients (i.e. high-risk sexual behaviour, partner with a sexually transmitted infection, homelessness or under housed, new or multiple sexual partners, or no prenatal care).

To help you manage the erythromycin eye ointment shortage, the MOHLTC, along with the Provincial Council for Maternal and Child Health, Maternal-Neonatal Committee and London Health Sciences Centre, Children’s Hospital, have developed algorithms that can be used for screening purposes and for responding to lab results. These algorithms are included with this Advisory Alert for your reference and have been posted on our website at

At this time, there is no recommended safe alternative medication to use prophylactically for newborns instead of erythromycin. Please continue to monitor your local supply closely, and if adequate supplies are not available, the decision to administer should be based on case-specific risk assessment and the attending providers’ clinical judgement.

Additionally, to support newborn primary care, facilities should include a note in the newborn record that is provided to parents indicating whether or not erythromycin ophthalmic ointment was administered. Parents and all neonatal health care providers should also be made aware of, and monitor for, symptoms of ophthalmia neonatorum occurring during the first four weeks of life. Signs and symptoms include:

Parents should seek immediate medical attention should signs and symptoms occur.

We will continue to provide you with updates regarding the availability of erythromycin ophthalmic ointment as we receive them. Once the supply of erythromycin returns to normal, routine administration of the ophthalmic prophylaxis to the eyes of newborns should continue as required under Regulation 557 Communicable Diseases – General under the Health Protection and Promotion Act.

For all reporting, inquiries or comments, please contact Public Health Sudbury & Districts at 705.522.9200, ext. 342.


Ariella Zbar, MD, CCFP, MPH, MBA, FRCPC
Associate Medical Officer of Health and Director, Clinical Services

This item was last modified on March 25, 2019