Drug Action
Chloramphenicol is a potent broad- Infection spectrum antibiotic.
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Drug reference
Chloramphenicol is a potent broad- Infection spectrum antibiotic.
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Life threatening infections particularly those caused by Haemophilus influenzae | Typhoid fever ▶BY MOUTH, OR BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: 12.5 mg/kg every 6 hours, in exceptional cases dose can be doubled for severe infections such as septicaemia and meningitis, providing high doses reduced as soon as clinically indicated
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Acute porphyrias p. 1120
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Avoid repeated courses and prolonged treatment
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→Appendix 1: chloramphenicol
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▶Rare or very rare ▶With parenteral use Aplastic anaemia (reversible or irreversible, with reports of resulting leukaemia) ▶Frequency not known ▶With oral use Bone marrow disorders. circulatory collapse. diarrhoea. enterocolitis. nausea. optic neuritis. oral disorders. ototoxicity. vomiting ▶With parenteral use Agranulocytosis. bone marrow disorders. depression. diarrhoea. dry mouth. fungal superinfection. headache. nausea. nerve disorders. thrombocytopenic purpura. urticaria. vision disorders. vomiting SIDE-EFFECTS, FURTHER INFORMATION Associated with serious haematological side-effects when given systemically and should therefore be reserved for the treatment of life-threatening infections.
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Manufacturer advises avoid; neonatal ‘grey- baby syndrome’ if used in third trimester.
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Manufacturer advises avoid; use another antibiotic; may cause bone-marrow toxicity in infant; concentration in milk usually insufficient to cause ‘grey syndrome’.
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Manufacturer advises caution (increased risk of bone-marrow depression)—monitor plasma-chloramphenicol concentration. Dose adjustments Manufacturer advises consider dose reduction. Monitoring Monitor plasma-chloramphenicol concentration in hepatic impairment.
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Avoid in severe renal impairment unless no alternative; dose-related depression of haematopoiesis.
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▶Plasma concentration monitoring preferred in the elderly. ▶Recommended peak plasma concentration (approx. 2 hours after administration by mouth, intravenous injection or infusion) 10–25 mg/litre; pre-dose (‘trough’) concentration should not exceed 15 mg/litre. ▶Blood counts required before and periodically during treatment.
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▶With intravenous use For intravenous infusion, give intermittently or via drip tubing in Glucose 5% or Sodium chloride 0.9%.
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There can be variation in the licensing of different medicines containing the same drug. Powder for solution for injection ELECTROLYTES: May contain Sodium ▶Chloramphenicol (Non-proprietary) Chloramphenicol (as Chloramphenicol sodium succinate) 1 gram Chloramphenicol 1g powder for solution for injection vials | 1 vial P £88.00 DT = £88.00 Capsule Infection ▶Chloramphenicol (Non-proprietary) Chloramphenicol 250 mg Chloramphenicol 250mg capsules | 60 capsule P £377.00 DT = £377.00
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12.5 mg/kg every 6 hours, in exceptional cases
First-line fragment. Read the complete Indications and Dose section above.
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