Chloramphenicol Antibiotic: Uses, Dosage & Side Effects

Summary of Key Points

Chloramphenicol is a powerful antibiotic used to treat a range of serious bacterial infections, including typhoid fever, bacterial meningitis, and certain eye infections. It works by stopping the growth of bacteria. While it is highly effective, Chloramphenicol is typically reserved for situations where other antibiotics are not suitable due to its potential for severe side effects. Always consult your healthcare provider before starting or adjusting your dosage. For personalized advice, consider scheduling a telemedicine appointment with one of our providers.

Names of the Medication

US Brand Name: Chloromycetin (Chloramphenicol)

The generic name refers to the active ingredient in the medication, while the brand name is assigned by the manufacturer. In this case, “Chloramphenicol” is the generic name, and “Chloromycetin” is the brand name.

Pharmacologic Category

Chloramphenicol belongs to the following pharmacologic category:

Antibiotic, Miscellaneous

Chloramphenicol Dosage

Chloramphenicol is prescribed for various serious infections, with the dosage tailored to the specific condition being treated. Always follow your healthcare provider’s instructions carefully and consult them before making any changes to your dose. If you need expert guidance, you can connect with one of our providers through telemedicine.

1. Typhoid Fever: 50 mg/kg/day, divided into four doses, taken every six hours for 14 days.
2. Bacterial Meningitis: 50-100 mg/kg/day, divided into four doses, taken every six hours for 10-14 days.
3. Rickettsial Infections: 50 mg/kg/day, divided into four doses, taken every six hours for 7-10 days.
4. Eye Infections: Apply 1-2 drops of a 0.5% solution to the affected eye every 2-6 hours until symptoms improve.
5. Pneumonia: 50-100 mg/kg/day, divided into four doses, taken every six hours for 10-14 days.
6. Brucellosis: 50 mg/kg/day, divided into four doses, taken every six hours for 3-6 weeks.
7. Cholera: 50 mg/kg/day, divided into four doses, taken every six hours for 3-5 days.
8. Plague: 50 mg/kg/day, divided into four doses, taken every six hours for 10 days.
9. Salmonella Infections: 50 mg/kg/day, divided into four doses, taken every six hours for 10-14 days.
10. Tularemia: 50 mg/kg/day, divided into four doses, taken every six hours for 10-14 days.

Dosage Forms and Strengths

Chloramphenicol is available in the following forms and strengths:

1. Oral Capsules: 250 mg
2. Intravenous (IV) Solution: 1 g/10 mL
3. Ophthalmic Solution (Eye Drops): 0.5%
4. Ophthalmic Ointment: 1%

Administration Instructions

Chloramphenicol can be administered orally, intravenously, or applied as eye drops or ointment, depending on the condition being treated. For oral forms, the medication can be taken with or without food, but always adhere to your healthcare provider’s instructions. For eye infections, apply the drops or ointment directly to the affected eye. Be sure to wash your hands thoroughly before and after application. If you miss a dose, take it as soon as you remember, but avoid doubling up on doses.

Chloramphenicol Side Effects and Adverse Reactions

As with any medication, Chloramphenicol may cause side effects. Some are mild and temporary, while others are rare but potentially serious. If you experience any side effects, contact your healthcare provider immediately. You can also schedule a telemedicine visit with us for further assistance.

1. Common Side Effects: Nausea, vomiting, diarrhea, and headache. These are usually mild and tend to resolve on their own.
2. Serious Side Effects: Bone marrow suppression, which can result in a significant decrease in blood cells, increasing the risk of severe infections or bleeding. This rare condition requires immediate medical attention.
3. Allergic Reactions: Symptoms may include rash, itching, swelling, severe dizziness, or difficulty breathing. Seek emergency medical care if these occur.
4. Gray Baby Syndrome: A rare but serious condition in newborns, characterized by symptoms such as vomiting, low blood pressure, and a grayish skin tone. This requires urgent medical intervention.

Contraindications of Chloramphenicol

A contraindication refers to a specific condition or circumstance in which a medication, such as **Chloramphenicol**, should not be used because it may pose significant risks to the patient. If you have any of the following conditions, it is crucial to avoid taking **Chloramphenicol** or consult your healthcare provider to carefully weigh the potential risks and benefits.

Allergy to Chloramphenicol: If you are allergic to **Chloramphenicol**, using this antibiotic could lead to a severe allergic reaction. Symptoms of an allergic response may include a rash, itching, swelling, or difficulty breathing. Seek immediate medical attention if you experience any of these symptoms.

Bone Marrow Suppression: **Chloramphenicol** can suppress the function of bone marrow, which may result in serious blood disorders such as aplastic anemia. If you have a history of bone marrow problems or blood-related conditions, this medication may not be safe for you and should only be used under strict medical supervision.

Liver Disease: Because **Chloramphenicol** is processed by the liver, individuals with liver disease may have difficulty metabolizing the drug effectively. This can lead to elevated levels of the medication in the bloodstream, increasing the likelihood of adverse effects. Your healthcare provider may recommend alternative treatments if you have liver impairment.

Newborns and Premature Infants: **Chloramphenicol** is contraindicated in newborns and premature infants due to their immature liver function. This can result in a potentially life-threatening condition known as “gray baby syndrome,” characterized by symptoms such as low blood pressure, cyanosis (a bluish tint to the skin), and difficulty breathing.

Drug-to-Drug Interactions with Chloramphenicol

**Chloramphenicol** can interact with other medications, potentially altering its effectiveness or increasing the risk of side effects. It is essential to inform your healthcare provider about all medications you are currently taking, including prescription drugs, over-the-counter medications, and dietary supplements. Below are some notable drug interactions to be aware of:

Warfarin (Coumadin): **Chloramphenicol** may enhance the effects of warfarin, a blood-thinning medication, which can increase the risk of excessive bleeding. Regular monitoring of blood clotting levels may be necessary if these drugs are used together.

Phenytoin (Dilantin): This antibiotic can elevate the levels of phenytoin, a medication used to manage seizures, potentially leading to toxic effects. Your doctor may need to adjust the dosage of phenytoin if you are prescribed **Chloramphenicol**.

Cyclosporine (Neoral, Sandimmune): **Chloramphenicol** may increase the concentration of cyclosporine in the blood. Cyclosporine is commonly used to prevent organ rejection after transplants, and higher levels can raise the risk of side effects. Close monitoring by your healthcare provider is recommended.

Rifampin (Rifadin): Rifampin can reduce the effectiveness of **Chloramphenicol** by speeding up its breakdown in the liver. If these medications are used together, your doctor may need to adjust the dosage or consider alternative treatments.

Chloramphenicol in Pregnancy

Is Chloramphenicol safe during pregnancy?

**Chloramphenicol** is generally not recommended during pregnancy, particularly in the later stages. This medication can cross the placenta and may harm the developing baby, potentially causing severe blood disorders or other complications. If you are pregnant or planning to become pregnant, it is essential to discuss the risks and benefits of **Chloramphenicol** with your healthcare provider. They may suggest safer alternative treatments that are more appropriate during pregnancy.

Chloramphenicol While Breastfeeding

Can you take Chloramphenicol while breastfeeding?

**Chloramphenicol** can pass into breast milk and may pose serious risks to a nursing infant, particularly if the baby is premature or has underlying health conditions. The medication can cause severe side effects in infants, such as bone marrow suppression. If you are breastfeeding, consult your healthcare provider before using **Chloramphenicol**. They may recommend alternative antibiotics that are safer for both you and your baby.

Estimated Cost of Chloramphenicol Medication

The cost of a 30-day supply of Chloramphenicol without insurance can vary depending on the pharmacy and location. With a GoodRx coupon, the estimated price typically ranges between $20 and $30 for a 30-day supply. However, prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a prescription discount service to find the most affordable option for your Chloramphenicol medication.

Possible Alternatives to Chloramphenicol

If Chloramphenicol is not an appropriate option for you, there are alternative treatments available for the conditions it is used to treat. It is essential to consult your healthcare provider before making any changes to your treatment plan. If needed, you can also schedule a telemedicine consultation with one of our providers to discuss your options in detail.

Alternatives for Specific Conditions

1. Typhoid Fever: Alternative antibiotics include ciprofloxacin or azithromycin. Vaccination is also an effective preventive measure.
2. Bacterial Meningitis: Depending on the specific bacteria causing the infection, alternatives may include ceftriaxone or vancomycin.
3. Rickettsial Infections: Doxycycline is often the preferred first-line treatment for these infections.
4. Eye Infections: For bacterial eye infections, topical antibiotics such as erythromycin or polymyxin B/trimethoprim may be suitable alternatives.
5. Pneumonia: Depending on the underlying cause, options may include amoxicillin, azithromycin, or levofloxacin.
6. Brucellosis: Treatment typically involves a combination of doxycycline and rifampin for effective results.
7. Cholera: Rehydration remains the cornerstone of treatment, but antibiotics such as doxycycline or azithromycin may be used in severe cases to shorten the duration of symptoms.
8. Plague: Streptomycin or gentamicin are commonly prescribed as alternatives to Chloramphenicol.
9. Salmonella Infections: While mild cases may resolve without treatment, severe infections can be managed with antibiotics like ciprofloxacin or azithromycin.
10. Tularemia: Streptomycin or gentamicin are frequently recommended as effective alternatives.

Recent Updates on Chloramphenicol Research

Recent research on Chloramphenicol has focused on its role in low-resource settings where access to alternative antibiotics may be limited. Studies are ongoing to better understand its safety profile, particularly in populations with restricted healthcare access. Researchers are also investigating the potential benefits of combining Chloramphenicol with other antibiotics to mitigate the risk of resistance. Despite these efforts, its use remains limited in many regions due to the potential for serious side effects. Always consult your healthcare provider for the most up-to-date information on Chloramphenicol and to determine whether it is the right treatment option for your specific needs.

James Kingsley

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