Other Brands/Names

How It Works

Chloramphenicol is an antibiotic that works by inhibiting the growth of bacteria, thereby helping to stop bacterial infections.

Indications

Chloramphenicol is used to treat a variety of serious bacterial infections, including:

• Meningitis (infection of the brain’s protective lining)

• Typhoid fever (a type of foodborne illness caused by Salmonella bacteria)

• Septicemia (blood poisoning caused by bacteria entering the bloodstream)

• Brain abscess (pus accumulation in the brain due to infection)

• Pelvic inflammatory disease

• Bacterial conjunctivitis (eye infection caused by bacteria)

• Otitis externa (outer ear infection)

Contraindications

• A history of allergy to chloramphenicol

• A history of aplasitic anemia (a blood disorder caused by the failure of bone marrow to produce blood cells)

• Acute porphyria (a group of diseases caused by the improper formation of heme, a part of hemoglobin)

• Use of live vaccines alongside chloramphenicol

• A perforated eardrum

• Pregnancy or breastfeeding

Side Effects

• Ototoxicity (damage to ear function)

• Eye irritation or burning sensation; long-term use can cause optic neuritis (inflammation of the optic nerve leading to vision disorders)

• Nausea, vomiting, mouth ulcers, and diarrhea

• Headache; long-term use can cause peripheral neuritis (damage to peripheral nerves, leading to weakness, numbness, and pain that usually occurs in the hands and legs)

• Mental symptoms, including confusion and mild depression

• Potentially fatal blood disorders (e.g. aplastic anemia), severe allergic reactions (rash, itching/swelling, especially of the face, tongue, or throat), severe dizziness, and breathing difficulty.

Types

Chloramphenicol is available in various forms, including tablets, capsules, syrups, and injectable solutions.

Dosage

Injection drugs

• Adults: 50 mg/kg per day, divided into 4 doses.

  • Severe infections (meningitis or severe infections due to resistant organisms): The dose may be increased to 100 mg/kg per day into divided doses.

• Children:

  • Premature newborns: 25 mg/kg per day in divided doses every 6 hours

  • Full-term newborns: 50 mg/kg per day in divided doses every 6 hours

Oral medications

• Adults: 50 mg/kg per day in 4 divided doses. Severe infections may require up to 100 mg/kg per day in 4 doses.
  
  • Severe infections (meningitis or severe infections due to resistant organisms): The dose may be increased to 100 mg/kg per day into divided doses.
  • Continue the treatment for 2-4 days after the patient’s temperature stabilizes in cases of rickettsial diseases and for 8-10 days in cases of typhoid fever (typhus).

Eye drops

• Adults and children >2 years old: Instill 1-2 drops into the affected eye 6 times a day, or more frequently if needed. The treatment should continue for at least 48 hours after recovery, with a treatment duration of 5 days.

Ear drops

• Adults: Instill 3-4 drops into the affected ear 2-3 times daily for 1 week.

Safety

• Regular monitoring of blood levels of chloramphenicol, liver, and kidney functions is essential.
• A complete blood count (CBC) should be performed at the start of treatment and every 2 days during therapy.
• Before starting treatment, culture and susceptibility tests are recommended to prevent antibiotic resistance.

Drug Interactions

• Chloramphenicol may increase the risk of bleeding when taken with anticoagulants (blood thinners), hypoglycemic agents (e.g., chlorpropamide), and antiepileptics (e.g., phenytoin).
• Liver enzyme-inducing drugs (e.g., phenobarbital - anticonvulsants, rifampin - antibiotics used to treat tuberculosis) can reduce chloramphenicol blood levels.
• Chloramphenicol may reduce the effects of iron and vitamin B12 in patients with anemia.
• Long-term use may reduce the effectiveness of oral contraceptives containing estrogen.
• Cytotoxic agents and sulfonamides (antibiotics) can increase the risk of blood poisoning when used with chloramphenicol.

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