Chloromycetin (chloramphenicol) is a powerful bacteriostatic antibiotic with a broad spectrum of activity against both Gram-positive and Gram-negative bacteria, as well as certain other microorganisms. It is particularly valued in clinical settings for its efficacy in treating serious infections where other antibiotics have failed or are contraindicated. Due to its potential for severe adverse effects, it is reserved for use in life-threatening conditions under strict medical supervision. This product card provides a comprehensive overview for healthcare professionals to ensure informed, safe, and effective prescribing practices.

Features

• Active ingredient: Chloramphenicol
• Available forms: Oral capsules, ophthalmic preparations, and intravenous solutions
• Mechanism of action: Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit
• Spectrum: Effective against a wide range of organisms, including Haemophilus influenzae, Salmonella typhi, Rickettsia, and Chlamydia
• Stability: Sensitive to light and moisture; requires protection during storage

Benefits

• Rapid bactericidal activity in high concentrations against susceptible organisms
• High tissue penetration, including cerebrospinal fluid, making it effective for meningitis
• Oral and parenteral formulations allow flexible administration based on clinical need
• Cost-effective option for certain severe infections in resource-limited settings
• Useful as a second-line agent when first-line antibiotics are ineffective or contraindicated

Common use

Chloromycetin is indicated for the treatment of serious infections caused by susceptible strains of microorganisms when less potentially hazardous agents are ineffective or contraindicated. Common uses include:

• Typhoid fever and other Salmonella infections
• Bacterial meningitis, particularly when caused by H. influenzae
• Rickettsial diseases such as Rocky Mountain spotted fever
• Ocular infections, including bacterial conjunctivitis (via ophthalmic preparations)
• Cystic fibrosis exacerbations involving susceptible Pseudomonas strains in certain cases

Dosage and direction

Dosage must be individualized based on the severity of the infection, susceptibility of the causative organism, and the patient’s age, weight, and renal/hepatic function. General guidelines include:

• Adults: 50 mg/kg/day in divided doses every 6 hours for systemic infections; maximum 4 g/day
• Children: 50–75 mg/kg/day in divided doses every 6 hours; monitor serum levels closely
• Neonates: 25 mg/kg/day in divided doses; avoid use in premature and full-term infants under 2 weeks old when possible
• Ophthalmic use: Apply 1–2 drops to affected eye(s) every 3–6 hours, depending on severity Administer around the clock to maintain effective serum concentrations. Complete the full course of therapy even if symptoms improve earlier.

Precautions

• Use only for serious infections where benefit outweighs risk due to potential for fatal aplastic anemia and bone marrow suppression
• Monitor complete blood counts before and during therapy; discontinue if signs of hematologic toxicity appear
• Avoid repeated courses of therapy; risk of adverse reactions may increase with subsequent exposures
• Use with caution in patients with hepatic or renal impairment; dosage adjustments may be necessary
• Not recommended for prophylaxis or treatment of trivial infections

Contraindications

• History of hypersensitivity to chloramphenicol or any component of the formulation
• Treatment of minor infections, prophylactic use, or infections treatable with other less dangerous antimicrobial agents
• Avoid in pregnancy (especially near term) and lactation unless potential benefit justifies potential risk to fetus/infant
• Contraindicated in patients with known bone marrow suppression or history of blood dyscrasias

Possible side effect

• Hematologic: Aplastic anemia, bone marrow depression, granulocytopenia, thrombocytopenia
• Gastrointestinal: Nausea, vomiting, diarrhea, glossitis, stomatitis
• Neurologic: Optic and peripheral neuritis, headache, depression, confusion
• Hypersensitivity reactions: Fever, rash, angioedema, anaphylaxis
• Other: Gray baby syndrome (in neonates), superinfections, blurred vision (with ophthalmic use)

Drug interaction

• Warfarin and other anticoagulants: Increased anticoagulant effect; monitor prothrombin time
• Phenytoin, phenobarbital: Altered metabolism; may increase or decrease serum levels of both drugs
• Sulfonylureas: Enhanced hypoglycemic effect
• Cyclophosphamide: May reduce its activation and efficacy
• Penicillins, cephalosporins: Antagonistic antibacterial effect possible; avoid concurrent use

Missed dose

If a dose is missed, administer it as soon as possible. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Informing the patient about the importance of adherence is crucial to maintain therapeutic levels and prevent resistance.

Overdose

Symptoms of overdose may include nausea, vomiting, gray baby syndrome (in infants), and bone marrow suppression. Treatment is supportive and symptomatic; there is no specific antidote. Hemodialysis is not effective for removal. In cases of recent ingestion, gastric lavage may be considered. Monitor hematologic parameters closely and provide supportive care for any organ toxicity.

Storage

• Store at controlled room temperature (15–30°C or 59–86°F)
• Protect from light and moisture
• Keep ophthalmic preparations tightly closed when not in use; do not freeze
• Keep out of reach of children and pets
• Do not use beyond the expiration date printed on the packaging

Disclaimer

This information is intended for healthcare professionals and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition or medication. The prescribing physician is responsible for determining appropriate dosage and monitoring therapy based on individual patient factors.

Reviews

Chloromycetin remains a critical agent in the antimicrobial arsenal for specific, severe infections. Clinical studies and expert consensus support its use in life-threatening situations where alternatives are not viable. However, its use is limited by toxicity concerns, and it is generally regarded as a drug of last resort. Healthcare providers emphasize the necessity of vigilant monitoring and strict adherence to prescribing guidelines to mitigate risks.