Other antibiotics / Chloramphenicol
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Chloramphenicol

Generic Name (active ingredient): Chloramphenicol
Brand Name: Laevomycetin, Chloromycetin, Phenicol, Brochlor, Chlorocid

Chloramphenicol is a broad-spectrum antibiotic. Clinical use of the drug is currently limited because it causes serious adverse reactions and, above all, has a toxic effect on the bone marrow.

How does the medication work?
Mechanism of antimicrobial action involves a violation of protein synthesis of microorganisms. Chloramphenicol has a bacteriostatic action. It is active against Gram-positive bacteria: Staphylococcus spp., Streptococcus spp.; Gram-negative bacteria: Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Haemophilus influenzae, Salmonella spp., Shigella spp., Klebsiella spp., Serratia spp., Yersinia spp., Proteus spp., Rickettsia spp.; Spirochaetaceae, and some large viruses.
Chloramphenicol is active against strains resistant to penicillin, streptomycin, sulphonamide.
Resistance of microorganisms to chloramphenicol develops relatively slowly.

When Chloramphenicol is prescribed?
Systemic use

  • Bacterial meningitis
  • Brain abscess
  • Generalized forms of salmonellosis
  • Typhoid fever
  • Rickettsial disease: Q fever, Rocky Mountains spotted fever, typhus
  • Intra-abdominal infections
  • Pelvic infections
  • Gas gangrene
  • Plague

Local

  • Bacterial infection of the eyes

What should I know before taking Chloramphenicol?
Do not use this medication if you are allergic to Chloramphenicol or to any other medicines such as:

  • Amphenicols

Do not take Chloramphenicol if any of the below conditions apply to you:

  • pregnancy
  • breastfeeding
  • newborn babies

Before taking Chloramphenicol, tell your health care provider about any other medicines you take or if you have any of the following disorders:

  • liver diseases
  • blood diseases

If you are pregnant, plan to become pregnant, or breastfeed, you should avoid taking Chloramphenicol. Chloramphenicol belongs to a pregnancy category C meaning that it may have a toxic effect on the fetus. Chloramphenicol penetrates into the breast milk in high concentrations (including ophthalmic formulations) and may have myelotoxic effect, so it should not be prescribed for nursing women.

How to take Chloramphenicol:
Chloramphenicol is available in the forms of capsules, eye drops, tablets, coated tablets, powder for injections, liniment.

Dosage of Chloramphenicol is prescribed individually by physician.

Take the entire amount of Chloramphenicol prescribed by your doctor, even if you feel better before the end of the treatment. If you stop taking medication too early, symptoms may return.
If you missed the scheduled dose, take the medication as soon as you remember, but skip the dose if it is almost the time for the following dose. Do not take two doses at once.

What are the side effects of Chloramphenicol?
Chloramphenicol may cause the following side effects:

  • Hematologic reactions:

- reversible (dose dependent): reticulopenia, thrombocytopenia, anemia, leukopenia;
- irreversible (not dose dependent, observed in people with genetic predisposition): aplastic anemia, prognostically unfavorable

  • Gray baby syndrome: vomiting, bloating, respiratory distress, cyanosis. Later may join vasomotor collapse, hypothermia, acidosis. The reason for the development of the gray syndrome is the accumulation of chloramphenicol due to immaturity of liver enzymes, and its direct toxic effect on the myocardium. The case fatality rate reaches 40%.
  • Nervous system: confusion, headache, peripheral neuropathy, mental disorders, with long-term use can develop optic neuritis with the risk of vision loss.
  • Gastrointestinal tract: glossitis, stomatitis, pain or discomfort in the abdomen, nausea, vomiting, diarrhea
  • Local reactions: burning, itching, swelling with the use of ophthalmic formulations

If you experience any side effect that last long or becomes bothersome, please inform your doctor as dose adjustment or treatment discontinuation may be required.

Which are Chloramphenicol overdose symptoms?
If you overdose Chloramphenicol, seek immediate medical attention. Overdose symptoms include: psychomotor disturbances, visual and auditory hallucinations, decreased hearing and sight.

Which other medicines may affect Chloramphenicol?
Chloramphenicol may interact with the following groups of drugs:

  • oral antidiabetic drugs
  • anti-epileptic drugs
  • indirect anticoagulants
  • microsomal liver enzymes inductors
  • preparations of iron, folic acid and vitamin B12
  • radiation therapy
  • cytostatic agents
  • H2-histamine antagonists
  • erythromycin and lincosamides

For a complete list of possible interactions ask your doctor or pharmacist. Before taking Chloramphenicol, let your doctor know what other medicines, including OTC, you currently take.

How should I store Chloramphenicol?
Store the drug in a cool place protected from direct light out of reach of the children.