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

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