Chloramphenicol (Chloromycetin)

Category:

• Antibiotic

Description:

• Miscellaneous antibiotic

Indications:

• Serious infections (Salmonella species, H. influenzae, meningeal infections, rickettsiae, lymphogranuloma-psittacosis group, various gram-negative bacteria, Bacteroides fragilis)

• Acute S. typhi infections (Typhoid fever)

• Cystic fibrosis

Contraindications:

• Not to be used for trivial infections or as prophylaxis

Precautions:

• Pregnancy category C

• Serious and fatal blood dyscrasias

• Aplastic anemia

• Preferably take on an empty stomach, but may take with food if GI upset occurs

• Take therapy at evenly spaced intervals (every 6 hours) around-the-clock

Adverse Reactions (Side Effects):

• CNS: Headache, mild depression, confusion

• Gastrointestinal upset, nausea, vomiting

• Gray Baby Syndrome

• toxic reactions including fatalities (40%) in premature infants and newborns

• usually seen if therapy is initiated in first 48 hours of life, symptoms appear within 3-4 days

• symptom progression: abdominal distention, pallid cyanosis, vasomotor collapse, irregular respiration, refusal to suckle, loose green stools, ashen color, hypothermia, death with a few hours of onset

Dosage:

• Administered orally and injection

• Adults:

  • 50mg/kg/day in divided doses every 6 hours

• meningitis/brain abscess: 

  • 100mg/kg/day in divided doses every 6 hours

• Children:

  • 50-75mg/kg/day in divided doses every 6 hours

• meningitis: 

  • 50-100mg/kg/day in divided doses every 6 hours

• Newborns:

  • neonates (< 2 kg): 25mg/kg once daily

  • birth to 7 days (> 2 kg): 25mg/kg once daily

  • > 7 days: 50mg/kg/day in divided doses every 12 hours