Chloramphenicol Overview

Chloramphenicol is an antibiotic used primarily for bacterial infections. It is classified as an effective broad-spectrum bacteriostatic antibiotic. Its mechanism of action involves inhibiting bacterial protein synthesis. This drug is often reserved for severe infections due to its potential for serious side effects.

Mechanism of Action

Chloramphenicol functions by binding to the 50S ribosomal subunit. This action suppresses bacterial protein synthesis. It effectively inhibits peptide bond formation. The antibiotic is notably effective against a wide range of Gram-positive and Gram-negative bacteria. Its capability to penetrate bacterial cells is significant, aiding in its action.

Indications for Use

Chloramphenicol is particularly indicated for severe infections. These include typhoid fever and meningitis. It has applications in treating serious respiratory infections. The drug is used when other medications are ineffective or contraindicated. It is also employed in treating certain anaerobic infections.

Available Forms

This medication is available in several formulations. Oral capsules and tablets are commonly used forms. An injectable form is available for severe systemic infections. Ophthalmic ointments and solutions are used for eye infections. Specific formulations vary depending on the country and manufacturer.

Prescription Criteria

Chloramphenicol should only be prescribed after confirming bacterial infection. Cultures and sensitivity tests often guide its use. It is generally not first-line therapy due to potential toxicity. The choice of this antibiotic often follows unsuccessful treatment with other antibiotics.

Dosage Recommendations

Dosage varies according to age, condition, and route of administration. Adult oral doses typically range from 50 to 100 mg/kg/day. Pediatric dosages are often calculated based on body weight. The frequency of dosing usually involves multiple times per day. Precise dosing must adhere to clinical guidelines.

Pharmacokinetic Properties

Chloramphenicol is well absorbed from the gastrointestinal tract. It exhibits widespread distribution in body tissues. The drug achieves high concentrations in the cerebrospinal fluid. Metabolism predominantly occurs in the liver. Renal excretion eliminates the inactive metabolites.

Side Effect Profile

This medication might cause blood dyscrasias, including aplastic anemia. Other potential side effects include gastrointestinal disturbances. Peripheral and optic neuropathy have been reported. Monitoring for hematological changes is essential. Secondary infections may occur due to broad-spectrum activity.

Drug Interactions

Chloramphenicol can interact with anticoagulant drugs. It may also affect the metabolism of phenytoin and other anticonvulsants. Concomitant use with bone marrow suppressants increases risk. Other antibiotics may antagonize its bacteriostatic effects. Comprehensive medication review is recommended prior to initiation.

Special Populations Consideration

Use in neonates is cautioned due to the risk of “gray baby syndrome.” Dosing adjustments are necessary for patients with hepatic impairment. Caution is advised when prescribing to elderly patients. It is advised to monitor levels in patients undergoing prolonged therapy. Special consideration is required for pregnant or breastfeeding women.

Storage Requirements

Chloramphenicol should be stored at controlled room temperature. Ophthalmic formulations may require refrigeration. Injectable forms, once prepared, have specific storage guidelines. Proper storage minimizes drug degradation. Always reference the specific product’s labeling for exact conditions.

Laboratory Monitoring

Regular blood counts are vital during treatment. Liver and renal functions require monitoring to avoid toxicity. Serum levels may need assessment in specific situations. Therapeutic levels should be maintained to prevent subtherapeutic dosing. Monitoring ensures safe and effective treatment.

Resistance Considerations

Emergence of resistance can limit chloramphenicol efficacy. Mechanisms include enzymatic inactivation. Bacterial modification of ribosomal targets also contributes. Judicious use mitigates the development of resistance. Detailed microbiological assessment aids in resistance management.

Patient Counseling

Patients should be instructed on the importance of adherence. Completion of prescribed course prevents resistance. Possible side effects and signs of toxicity warrant explanation. Importance of reporting unusual symptoms should be stressed. Proper administration technique for different formulations is important.