Chloramphenicol: Difference between revisions

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


==Adult Dosing==
==Adult Dosing==
===Infection, General===
===Infection, General===
*50-100 mg/kg/day IV divided q6h
*50-100mg/kg/day IV divided q6h


===Bacterial [[meningitis]]===
===Indications by Disease===
*4 g/day IV divided q6h
{{#ask: [[Has DrugName::Chloramphenicol]] [[Has Population::Adult]]
*Alt: 75-100 mg/kg/day IV divided qgh
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|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
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==Pediatric Dosing==
==Pediatric Dosing==
===Bacterial meningitis===
 
*75-100 mg/kg/day IV divided q6h; Max 4g/day
 
===Indications by Disease===
{{#ask: [[Has DrugName::Chloramphenicol]] [[Has Population::Pediatric]]
|?Treats disease=Disease
|?Has Dose=Dose
|?Has Context=Context
|format=table
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==Special Populations==
==Special Populations==
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==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
* aplastic anemia
*[[aplastic anemia]]
* agranulocytosis
*agranulocytosis
* thrombocytopenia
*[[thrombocytopenia]]
* anaphylaxis
*[[anaphylaxis]]
* gray baby syndrome
*gray baby syndrome
* pseudomembranous colitis
*pseudomembranous colitis


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


==Pharmacology==
==Pharmacology==
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*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


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


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

Latest revision as of 11:08, 20 March 2026

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

Indications by Disease

DiseaseDoseContext
Bacterial conjunctivitis0.5% ophthalmic solution 1 drop QID for 7 daysBacterial Conjunctivitis, Topical
Plague25mg/kg PO q6hrsPostexposure prophylaxis age over 2 only
Rocky mountain spotted fever50-100mg/kg/day div q6hrs (max 4g/day)Preferred in pregnancy
Tularemia15mg/kg IV q6hrs x 14 daysActive disease

Pediatric Dosing

Indications by Disease

DiseaseDoseContext
Plague25mg/kg PO/IV q6hrs (max 4g/day); age >2 onlyPediatric Prophylaxis
Rocky mountain spotted fever50-100mg/kg/day IV divided q6hrs (max 4g/day)Pediatric Doxycycline Allergy

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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