Abstract
Prophylaxis for ophthalmia neonatorum remains in use despite decreased incidence of the condition. We report a breakthrough case of neonatal conjunctivitis in Japan caused by a levofloxacin-resistant Neisseria gonorrhoeae bacteria strain, co-infected with Chlamydia trachomatis bacteria. This case highlights failures in screening, prophylaxis, and treatment, underscoring the need to reassess prevention strategies.