chloramphenicol

BRAND NAME: Chloromycetin, Econochlor, Ocu-Chlor (These are discontinued brands in the US)

DRUG CLASS AND MECHANISM: Chloramphenicol is a man-made antibiotic. It slows growth of bacteria by preventing them from producing important proteins that they need to survive. Chloramphenicol is effective against S. typhi, H. influenzae, E. coli, Neisseria species, Staphylococcus and Streptococcus species, Rickettsia, and lymphogranuloma-psittacosis group of organisms. The FDA approved chloramphenicol in December 1950.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Chloramphenicol is available in 0.5% sterile eye drops and 1% eye ointment. Eye drops are available in 2.5 ml and 15 ml drop-containers. Ointments are available in 3.5 g tubes.

Chloramphenicol sodium succinate is available as 1 gram/10 ml per vial powder for intravenous injection form.

STORAGE: Chloramphenicol eye drops are refrigerated until dispensed. Chloramphenicol ointments are stored between 46 F and 80 F. Chloramphenicol vials for IV reconstitution are stored between 20 C and 25 C (68 F and 77 F).

PRESCRIBED FOR: Chloramphenicol treats various infections caused by susceptible strains of S. yphi, H. influenzae, E. coli, Neisseria species, Staphylococcus and Streptococcusspecies, Rickettsia, lymphogranuloma-psittacosis group of organisms, and other bacteria that cause bacteremia (bacteria in blood) and meningitis.

DOSING:

Eye drop solution:

• Mild disease: Instill 1 to 2 drops into the affected eye(s) up to 4 times a day
• Severe disease: Instill 2 hours into the affected eye(s) every hour until improvement.
• Eye ointment: Apply a small amount to the affected lower conjunctival sac(s) at bedtime as a supplement to the drops.

Intravenous (IV):

• Adults: 50 to 100 mg/kg IV every 6 hours.
• Children: 50 mg/kg IV every 6 hours; may increase to 100 mg/kg IV every 6 hours in severe illness.
• Newborn infants: 25 mg/kg IV every 6 hours. Newborns over 2 weeks old may receive 50 mg/kg every 6 hours.

DRUG INTERACTIONS: Chloramphenicol should not be used with lurasidone (Latuda) because chloramphenicol significantly lowers lurasidone's metabolism and increases its levels in the body.

Chloramphenicol should be used cautiously with red yeast rice, warfarin (Coumadin), and vilazodone (Viibryd) because chloramphenicol lowers their metabolism and increases those drug levels in the body.

PREGNANCY: There are no adequate studies done on chloramphenicol to determine safe and effective use in pregnant women.

NURSING MOTHERS: Chloramphenicol enters breast milk. Therefore, it should not be used in nursing mothers.

SIDE EFFECTS: Side effects of chloramphenicol are headache, mental confusion, fever, rash, diarrhea, and optic atrophy.

Chloramphenicol may cause Gray syndrome and serious, fatal blood dyscrasias. Gray syndrome occurs in pre-mature infants and neonates. It involves abdominal distention, pallid cyanosis, and vasomotor collapse leading to death. Blood dyscrasias are reductions in blood cells leading to aplastic anemia, thrombocytopenia, and granulocytopenia.

QUESTION

Which illness is known as a viral upper respiratory tract infection? See Answer