Chloramphenicol: Potent Broad-Spectrum Antibiotic Therapy
Similar products
Chloramphenicol is a bacteriostatic antibiotic with a broad spectrum of activity against both Gram-positive and Gram-negative bacteria, as well as certain other microorganisms. It functions by inhibiting bacterial protein synthesis through binding to the 50S ribosomal subunit, making it a critical agent in managing serious infections where other antibiotics are ineffective or contraindicated. Its use is reserved for severe infections due to potential hematologic toxicity, requiring careful clinical oversight and monitoring.
Features
- Broad-spectrum activity against aerobic and anaerobic bacteria
- Available in oral, topical, and intravenous formulations
- Inhibits bacterial protein synthesis at the ribosomal level
- Effective against multidrug-resistant organisms in certain contexts
- Can penetrate tissues and body fluids, including the central nervous system
Benefits
- Provides reliable treatment for serious systemic infections when first-line options fail
- Effective against a wide range of pathogens, including Salmonella typhi and Haemophilus influenzae
- Suitable for use in ocular infections with high efficacy and good tissue penetration
- Can be a lifesaving option in resource-limited settings for specific severe infections
- Offers flexibility in administration routes to suit clinical needs
Common use
Chloramphenicol is indicated for the treatment of serious infections caused by susceptible organisms. These may include typhoid fever, bacterial meningitis, rickettsial diseases, and certain anaerobic infections. It is also commonly used topically for bacterial conjunctivitis and otitis externa. Due to its risk profile, it is generally reserved for situations where less toxic antimicrobial agents are ineffective or contraindicated.
Dosage and direction
Dosage must be individualized based on the infection severity, patient weight, renal function, and susceptibility of the causative organisms. For adults, typical intravenous or oral doses range from 50–100 mg/kg/day, divided into 4 doses. In meningeal infections, higher doses may be required. Topical formulations are applied directly to the affected area 3–4 times daily. Duration of therapy should be as short as possible to minimize adverse effects, typically not exceeding two weeks without reassessment.
Precautions
Complete blood counts should be monitored before and during therapy to detect potential hematologic toxicity. Use with caution in patients with hepatic or renal impairment, as dose adjustments may be necessary. Avoid prolonged use to reduce the risk of bone marrow suppression or secondary infections. Patients should be advised to report any signs of infection, fatigue, or unusual bleeding promptly.
Contraindications
Chloramphenicol is contraindicated in patients with a history of hypersensitivity to the drug. It should not be used for trivial infections, as prophylaxis, or in patients with pre-existing bone marrow suppression. Avoid concurrent use with other drugs that cause bone marrow suppression. Not recommended during pregnancy (especially near term) and lactation unless potential benefits outweigh risks.
Possible side effect
- Bone marrow suppression (dose-related and idiosyncratic)
- Gray baby syndrome in neonates
- Optic and peripheral neuritis with prolonged use
- Nausea, vomiting, diarrhea
- Hypersensitivity reactions
- Superinfections including fungal overgrowth
Drug interaction
Chloramphenicol may inhibit the metabolism of drugs such as warfarin, phenytoin, and chlorpropamide, increasing their plasma levels and toxicity. Concurrent use with other myelosuppressive agents (e.g., chemotherapeutic drugs) increases the risk of hematologic adverse effects. It may antagonize the bactericidal activity of penicillins and aminoglycosides in certain situations.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next dose. Do not double the dose to catch up. Maintaining consistent serum levels is important for efficacy, but irregular dosing can increase the risk of resistance or treatment failure.
Overdose
Symptoms of overdose may include nausea, vomiting, altered mental status, and cardiovascular collapse. Hematologic toxicity is of particular concern. Treatment is supportive and may include gastric lavage if ingestion was recent, along with monitoring of blood counts and vital signs. Hemodialysis is not effective for removal.
Storage
Store at room temperature (15–30°C), protected from light and moisture. Keep out of reach of children. Do not use beyond the expiration date. Oral suspensions should be discarded after 14 days unless specified otherwise by the manufacturer.
Disclaimer
This information is intended for medical professionals and should not replace clinical judgment. Chloramphenicol must be prescribed by a qualified healthcare provider following appropriate diagnosis and risk-benefit assessment. Always adhere to local prescribing guidelines and regulatory approvals.
Reviews
“Chloramphenicol remains a valuable agent in our arsenal for multidrug-resistant typhoid and bacterial meningitis in settings with limited options. Hematologic monitoring is non-negotiable.” – Infectious Disease Specialist
“Topical chloramphenicol is highly effective for bacterial conjunctivitis, though we reserve it for cases unresponsive to first-line treatments.” – Ophthalmologist
“While its use has declined in high-resource settings due to toxicity concerns, it is still irreplaceable in certain severe systemic infections under careful supervision.” – Clinical Pharmacologist