In the pre-antibiotic era gonorrhea showed a high prevalence also in industrialized countries. In Germany, more than 10% of
all newborns developed gonorrheal ophthalmia neonatorum. Clinical courses of gonorrheal ophthalmia neonatorum were quite different
in their severity but often caused significant impairment of eyesight up to total blindness in more than 5%. This accounted
for 25–40% of cases of blindness in Germany. It was Carl Siegmund Franz Credé (1819–1892), a German obstetrician, who introduced
the eye prophylaxis of eye drops containing 2% silver nitrate solution to every newborn child in his clinic in Leipzig on
June 1st 1880. The incidence of gonorrheal ophthalmia neonatorum immediately decreased from 10% to 0%. Credé actively communicated
these results and immediately published them in four publications within a time period of 3 years. These publications, which
are discussed here, are written in a very pragmatic and strictly clinical style, ignoring new basic scientific insights into
the microbiology of gonorrhea and the discovery of the corresponding pathogen, the “Micrococcus” by Albert Neisser, which Credé considered unimportant for his purposes. Against a high degree of opposition by many physicians,
Credé put all enthusiasm into the call for education of midwives in this technique. Credé knew that this was the central way
to ensure that all newborns could obtain this prophylaxis, including outpatients and home deliveries. Credé’s eloquence led
to the rapid spreading of “his” eye prophylaxis over the rest of the world. The concentration of silver nitrate was often
reduced from 2% to 1% thereafter and in most countries the performance of this prophylaxis was rapidly enforced by law. By
introducing this method, Credé saved or improved the eyesight of millions of people — a significant contribution to obstetrics,
neonatology and pediatrics, ophthalmology and mankind. Still today, in the antibiotic era, other topical regimens for antiseptic
prophylaxis against ophthalmia neonatorum are often referred to as “Credé’s prophylaxis”.