Chloramphenicol is an antibiotic useful for the treatment of a number of bacterial infections. This includes as an eye ointment to treat conjunctivitis. By mouth or by injection into a vein, it is used to treat meningitis, plague, cholera, and typhoid fever.
Broad spectrum antimicrobial
Chloramphenicol is a broad-spectrum bacteriostatic antibiotic which acts through the inhibition of bacterial protein synthesis by interfering with the transfer of activated amino acids from soluble RNA to ribosomes.
ORAL Bacterial meningitis; Brain abscess; Granuloma inguinale; Anthrax; Listeriosis; Gas gangrene; Whipple’s disease; Severe systemic infections wI Camphylobacter fetus; Infections caused by H. influenzae; Ehrlichiosis; Severe gastroenteritis; Severe melioidosis; Plague;Psittacosis; 0 fever; Anaerobic bacterial infections; Tularaemia: Adult: 50 mg/kg/day in 4 divided doses increased to 100 mg/kg/day for meningitis or severe infections due to moderately resistant organisms. Continue treatment after the patient’s temp has norrnalised for a further 4 days in rickettsial disease & 8-10 days in typhoid fever. Child: Premature & full-term neonates: 25 mg/kg/day in 4 divided doses. Full-term infants >2 wk: 50 mg/kg/day in 4 divided doses. Children: 50 mgI kg/day in 4 divided doses increased to 100 mg/kg/day for meningitis or severe infections.
Chymotrypsin may be inhibited if given simultaneously with Chloramphenicol.
History of hypersensitivity or toxic reaction to the drug; pregnancy, lactation; porphyria; parenteral admin for minor infections or as prophylaxis; preexisting bone marrow depression or blood dyscrasias. Impaired renal or hepatic function; premature & full-term neonates. Monitor plasma concentrations to avoid toxicity.
GI symptoms: bleeding; peripheral & optic neuritis, visual impairment, blindness; encephalopathy, confusion, delirium, mental depression, headache. Haemolysis in patients w/ G6PD deficiency. ophth application: Hypersensitivity reactions including rashes, fever & angioedema. Ear drops: Ototoxicity. Bone marrow suppression & irreversible aplastic anaemia. Neutropenia, thrombocytopenia. Grey baby syndrome. Rarely, anaphylaxis.
Chloramphenicol has been assigned pregnancy category C by the FDA. Animal studies have not been reported. There are no controlled data in human pregnancies. Oral chloramphenicol crosses the placenta. While there are no literature reports linking the use of chloramphenicol in pregnancy to birth defects, use late in pregnancy has been associated with adverse effects in the neonate (i.e. gray baby syndrome). Chloramphenicol should only be given during pregnancy when benefit outweighs risk. Use near term is considered contraindicated by some experts. Chloramphenicol is excreted into human milk. Adverse effects have been noted in nursing infants, including refusal of the breast, intestinal gas, and heavy vomiting. In addition, there is a theoretic risk of idiosyncratic bone marrow suppression and Gray Syndrome in the infant. For this reason, use of chloramphenicol during lactation is considered to be of concern by the American Academy of Pediatrics and contraindicated by others. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Accidental ingestion of the medicine is unlikely to cause any toxicity due to low content of antibiotic.
Store in a cool (between 2°C-8°C) and dry place, protect from light, keep out of reach of children. Do not touch the dropper tip to the surface since this may contaminate the solution. Do not use after 30 days of the first opening.
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