Chloramphenicol: Difference between revisions

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==General==
==General==
*Type:  
*Type: bacteriostatic [[antibiotic]]
*Dosage Forms:
*Dosage Forms: IV, IM, eye drops
*Common Trade Names:  
*Common Trade Names: pentamycetin, chloromycetin


==Adult Dosing==
==Adult Dosing==
===Infection, General===
*50-100mg/kg/day IV divided q6h
===Bacterial [[meningitis]]===
*4 g/day IV divided q6h
*Alt: 75-100mg/kg/day IV divided qgh
===Bacterial [[conjunctivitis]]===
*0.5% ophthalmic solution 1 drop QID for 7 days


==Pediatric Dosing==
==Pediatric Dosing==
===Bacterial meningitis===
*75-100mg/kg/day IV divided q6h; Max 4g/day


==Special Populations==
==Special Populations==
*Pregnancy:
*Pregnancy: Category C (risk not ruled out)
*Lactation:
*Lactation: passes into breast milk and should be avoided if possible
*Renal Dosing
*Renal Dosing: minimally excreted via kidneys
**Adult
**Adult: amount not defined
**Pediatric
**Pediatric: amount not defined
*Hepatic Dosing
*Hepatic Dosing: metabolized by the liver, therefore dose must be reduced
**Adult
**Adult: amount not defined
**Pediatric
**Pediatric: amount not defined


==Contraindications==
==Contraindications==
Line 23: Line 34:
==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*[[aplastic anemia]]
*agranulocytosis
*[[thrombocytopenia]]
*[[anaphylaxis]]
*gray baby syndrome
*pseudomembranous colitis


===Common===
===Common===
*headache
*nausea, vomiting
*diarrhea
*fever
*rash
*urticaria
*peripheral neuropathy
*blurred vision


==Pharmacology==
==Pharmacology==
*Half-life:  
*Half-life: 1.5 - 4.1 hours
*Metabolism:  
*Metabolism: Liver
*Excretion:  
*Excretion: Urine
*Mechanism of Action:
*Mechanism of Action: binds to 50S ribosomal subunit inhibiting protein synthesis
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||X1
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||I
|-
| ||[[Enterococcus faecium]]||I
|-
| ||[[MSSA]]||I
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||X1
|-
| ||[[Staph. Epidermidis]]||R
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||'''S'''
|-
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||I
|-
| ||E. coli/Klebsiella ESBL+||I
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||R
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||X1
|-
| ||Serratia marcescens||R
|-
| ||[[Salmonella]] sp||'''S'''
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||X1
|-
| ||[[Proteus vulgaris]]||I
|-
| ||[[Providencia sp.]]||X1
|-
| ||[[Morganella sp.]]||X1
|-
| ||[[Citrobacter freundii]]||X1
|-
| ||[[Citrobacter diversus]]||X1
|-
| ||[[Citrobacter sp.]]||X1
|-
| ||[[Aeromonas sp]]||X1
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||'''S'''
|-
| ||[[Stenotrophomonas maltophilia]]||'''S'''
|-
| ||[[Yersinia enterocolitica]]||'''S'''
|-
| ||[[Francisella tularensis]]||'''S'''
|-
| ||[[Brucella sp.]]||'''S'''
|-
| ||[[Legionella sp.]]||X1
|-
| ||[[Pasteurella multocida]]||X1
|-
| ||[[Haemophilus ducreyi]]||X2
|-
| ||[[Vibrio vulnificus]]||X2
|-
| Misc||[[Chlamydophila sp]]||'''S'''
|-
| ||[[Mycoplasm pneumoniae]]||'''S'''
|-
| ||[[Rickettsia sp]]||'''S'''
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||X2
|-
| ||[[Bacteroides fragilis]]||X2
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||I
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
 
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


==Source==
==References==
<references/>


<references/>
[[Category:Pharmacology]] [[Category:ID]]
[[Category:Drugs]]

Latest revision as of 16:43, 15 March 2023

General

  • Type: bacteriostatic antibiotic
  • Dosage Forms: IV, IM, eye drops
  • Common Trade Names: pentamycetin, chloromycetin

Adult Dosing

Infection, General

  • 50-100mg/kg/day IV divided q6h

Bacterial meningitis

  • 4 g/day IV divided q6h
  • Alt: 75-100mg/kg/day IV divided qgh

Bacterial conjunctivitis

  • 0.5% ophthalmic solution 1 drop QID for 7 days

Pediatric Dosing

Bacterial meningitis

  • 75-100mg/kg/day IV divided q6h; Max 4g/day

Special Populations

  • Pregnancy: Category C (risk not ruled out)
  • Lactation: passes into breast milk and should be avoided if possible
  • Renal Dosing: minimally excreted via kidneys
    • Adult: amount not defined
    • Pediatric: amount not defined
  • Hepatic Dosing: metabolized by the liver, therefore dose must be reduced
    • Adult: amount not defined
    • Pediatric: amount not defined

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

  • headache
  • nausea, vomiting
  • diarrhea
  • fever
  • rash
  • urticaria
  • peripheral neuropathy
  • blurred vision

Pharmacology

  • Half-life: 1.5 - 4.1 hours
  • Metabolism: Liver
  • Excretion: Urine
  • Mechanism of Action: binds to 50S ribosomal subunit inhibiting protein synthesis

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep X1
Strep. anginosus gp X1
Enterococcus faecalis I
Enterococcus faecium I
MSSA I
MRSA R
CA-MRSA X1
Staph. Epidermidis R
C. jeikeium R
L. monocytogenes S
Gram Negatives N. gonorrhoeae S
N. meningitidis S
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp I
E. coli/Klebsiella ESBL+ I
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp X1
Serratia marcescens R
Salmonella sp S
Shigella sp S
Proteus mirabilis X1
Proteus vulgaris I
Providencia sp. X1
Morganella sp. X1
Citrobacter freundii X1
Citrobacter diversus X1
Citrobacter sp. X1
Aeromonas sp X1
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia S
Stenotrophomonas maltophilia S
Yersinia enterocolitica S
Francisella tularensis S
Brucella sp. S
Legionella sp. X1
Pasteurella multocida X1
Haemophilus ducreyi X2
Vibrio vulnificus X2
Misc Chlamydophila sp S
Mycoplasm pneumoniae S
Rickettsia sp S
Mycobacterium avium X1
Anaerobes Actinomyces X2
Bacteroides fragilis X2
Prevotella melaninogenica S
Clostridium difficile I
Clostridium (not difficile) S
Fusobacterium necrophorum S
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ Sanford Guide to Antimicrobial Therapy 2014
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