Chloramphenicol

Listed in Dosage.

Adult: PO Susceptible infections 50 mg/kg/day in 4 divided doses; up to 100 mg/kg/day for meningitis or severe infections due to moderately resistant organisms. IV Typhoid fever; Septicaemia; Meningitis 50 mg/kg/day in divided doses at 6 hourly intervals. Severe infections (e.g. meningitis) or infections due to moderately resistant organisms: Up to 100 mg/kg/day, decreased as soon as possible. Ophthalmic Bacterial conjunctivitis As 0.5% solution: Instill 1-2 drops to the affected eye(s) 6 times/day or more frequently as necessary. As 1% ointment: Apply approx 1 cm of ointment to the affected eye(s) 3-4 hourly or more frequently as required. Treatment duration: 5 days. Otic Otitis externa As 5% or 10% solution: Instill 3-4 drops into the affected ear(s) bid-tid for up to 1 week.

Should be taken on an empty stomach. Take on an empty stomach 1 hr before or 2 hr after meals.

Hypersensitivity. Known or family history of blood dyscrasias (e.g. aplastic anaemia), acute porphyria, active immunisation. Perforated eardrum (otic). Pregnancy and lactation (oral, IV). Concomitant administration of drugs that cause bone marrow depression.

Avoid prolonged use. Not indicated for treatment of viral infections or for prophylaxis of bacterial infections. Renal and hepatic impairment. Children. Pregnancy and lactation (ophthalmic, otic). Patient Counselling Eye drops may cause transient blurred vision, if affected do not drive or operate machinery. Monitoring Parameters Monitor chloramphenicol plasma concentration, hepatic and renal functions periodically. Check CBC with differential at baseline and every 2 days during treatment. Perform culture and susceptibility tests; consult local recommendations before treatment initiation due to antibiotic resistance risks.

Ear and labyrinth disorders: Ototoxicity. Eye disorders: Transient stinging and irritation (ophthalmic), optic neuritis (prolonged use). Gastrointestinal disorders: Nausea, vomiting, glossitis, stomatitis, diarrhoea, enterocolitis. Nervous system disorders: Headache, peripheral neuritis (prolonged use). Psychiatric disorders: Delirium, mental confusion, mild depression.
Potentially Fatal: Blood dyscrasias (e.g. aplastic anaemia, hypoplastic anaemia, thrombocytopenia, granulocytopenia), Grey baby syndrome, hypersensitivity reactions (e.g. angioedema, anaphylaxis, urticaria, fever, vesicular and maculopapular dermatitis), superinfection (e.g. C. difficile-associated diarrhoea and pseudomembranous colitis).

Enhances the effects of coumarin anticoagulants (e.g. dicoumarol, warfarin), certain hypoglycaemics (e.g. chlorpropamide, tolbutamide) and antiepileptics (e.g. phenytoin). Hepatic enzyme inducers (e.g. phenobarbital, rifampicin) may decrease chloramphenicol plasma concentrations. May decrease the effects of Fe and vit B12 in anaemic patients. Prolonged treatment may reduce the efficacy of oestrogen-containing oral contraceptives. May increase the plasma levels of calcineurin inhibitors (e.g. tacrolimus, ciclosporin).

Ear Anti-Infectives & Antiseptics / Eye Anti-Infectives & Antiseptics / Chloramphenicols

S01AA01 - chloramphenicol ; Belongs to the class of antibiotics. Used in the treatment of eye infections.
D06AX02 - chloramphenicol ; Belongs to the class of other topical antibiotics used in the treatment of dermatological diseases.
S03AA08 - chloramphenicol ; Belongs to the class of antiinfectives used in ophthalmologic and otologic preparations.
J01BA01 - chloramphenicol ; Belongs to the class of amphenicols. Used in the systemic treatment of infections.
S02AA01 - chloramphenicol ; Belongs to the class of antiinfectives used in the treatment of ear infections.
G01AA05 - chloramphenicol ; Belongs to the class of antibiotics. Used in the treatment of gynecological infections.
D10AF03 - chloramphenicol ; Belongs to the class of topical antiinfective preparations used in the treatment of acne.