What is chloramphenicol? Benefits and side effects of Chloramphenicol

In recent decades, there have been significant advances in the field of medicine and pharmaceuticals, which have led to the development and improvement of various treatments. One of the drugs that plays an important role in this regard is chloramphenicol. This drug is known as a tetracycline antibiotic and is used to treat bacterial infections in humans. Considering the importance of the topic and prominent role of chloramphenicol drug in the pharmaceutical industry and health improvement, this article can provide the best source of information for those who seek a deeper understanding of this drug.

Pharmaceutical forms of chloramphenicol

1. Injectable solution 1000 mg per vial
2. drop

Uses of chloramphenicol

Chloramphenicol injection is used to treat certain types of serious bacterial infections when other antibiotics cannot be used. These drugs are in a class of drugs called antibiotics, which work by stopping the growth of bacteria. It should be noted that antibiotics such as chloramphenicol injection are not effective for colds, flu, or other viral infections. Taking antibiotics when they are not needed increases the risk of developing an infection that later becomes resistant to antibiotic treatment.

Pharmacological effects and mechanism of action of chloramphenicol drug

Pharmacology Chloramphenicol is present in most body tissues and fluids and easily crosses the placenta. This drug is extensively hepatic (90%) to inactive metabolites, mainly by glucuronidation, and chloramphenicol palmitate is hydrolyzed to the active base by lipases in the gastrointestinal tract. Chloramphenicol sodium succinate is hydrolyzed by esterases and reaches the active base. The mechanism of action of this drug inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit.

Dosage of chloramphenicol

Chloramphenicol is an intravenous liquid that is injected into a vein by a doctor or nurse in a hospital and is usually taken once every 6 hours. The length of your treatment depends on the type of infection being treated. After your condition improves, your doctor may switch you to another antibiotic that you can take by mouth to complete the treatment. You should feel better in the first few days of treatment with chloramphenicol injection. If your symptoms do not improve or get worse, tell your doctor. Take this medicine according to the doctor’s prescription, stopping the medicine early will cause the disease to return.

Time to take chloramphenicol

1. For the treatment of serious infections caused by sensitive strains, 50 mg/kg is prescribed as an intravenous injection. In exceptional cases, patients with relatively resistant organisms or severe infections may need to increase the dose to 100 mg/kg daily.
2. For use in other cases only use as an alternative to treat meningitis, typhoid or rickettsial infection.
3. Treatment of systemic infections in children and infants is the same as in adults. 100 mg/kg daily may be required when the patient has sufficient CSF concentration. However, the dose should be reduced to 50 mg/kg daily as soon as possible.
4. Infants and children with suspected metabolic immaturity: 25 mg/kg/day divided over 6 hours, which usually produces therapeutic blood concentrations of the drug.
5. Infants (less than 28 days) with a loading dose (LdD): 20 mg/kg as a single intravenous injection with a maintenance dose administered 12 hours after the loading dose.
6. General maintenance dose less than 7 days 25 mg/kg by intravenous injection, more than 7 days (less than 2000 g) 25 mg/kg in 24 hours and for more than 7 days (more than 2000 g) 50 mg Gram/kg per day is consumed divided in 12 hours.

Precautions

Before taking chloramphenicol, if you are allergic to it or other ingredients in the medicine, avoid using it. This medicine may contain inactive ingredients that can cause allergic reactions or other problems. People with medical records such as cardiovascular disorders, lung or liver problems, shortness of breath, specific lung or kidney infection, sensitivity or allergy to antibiotics, etc. should use this medicine with caution. If you have experienced side effects after taking this medicine in the past, inform your doctor so that he can change the prescription if necessary.

1. If possible, avoid repeated courses of chloramphenicol treatment.
2. Do not continue treatment longer than necessary to treat the disease with low or no risk of disease recurrence.
3. Impaired liver or kidney function may cause blood levels of the drug to rise above the recommended dose. In this regard, adjust your dosage based on this process; Also, it is preferable to determine the blood concentration at appropriate intervals.
4. The use of antibiotics may lead to overgrowth of non-susceptible organisms, including fungi. Take appropriate action if non-susceptible organisms appear during treatment.
5. Gray syndrome has been reported in premature infants and neonates. Abdominal distension with or without vomiting, progressive pale cyanosis, vasomotor collapse, often associated with irregular breathing, and death within hours of the onset of these symptoms. It may also be associated with serum levels >50 mcg/mL after repeated doses.

Blood dyscrasias of chloramphenicol drug

1. Serious and fatal blood dyscrasias (aplastic anemia, thrombocytopenia, and granulocytopenia) have been reported after administration of chloramphenicol.
2. An irreversible type of bone marrow depression leading to aplastic anemia with a high mortality rate is characterized by the appearance of bone marrow aplastic or hypoplasia weeks or months after treatment.
3. Peripherally, pancytopenia is often observed, but in a small number of cases only one or two of the three major cell types (erythrocytes, leukocytes, platelets) may be depressed.
4. A reversible form of bone marrow depression, which is dose-dependent, occurs in some patients. This type of brain depression is characterized by vacuolization of erythroid cells, reduction of reticulocytes and leukopenia and responds to discontinuation of treatment.
5. Due to the lack of accurate information on the size of the population at risk, the total number of drug-related dyscrasias, and the total number of non-drug-related dyscrasias, it is not possible to accurately determine the risk of serious and fatal blood dyscrasias.

Chloramphenicol contraindications

1. Hypersensitivity
2. Oral or topical use
3. Bacterial prophylaxis
4. Viral infections

Side effects of chloramphenicol

Nightmare, diarrhea, nausea, vomiting, hives, headache, aplastic anemia, Gray’s syndrome, etc. are some of the side effects of chloramphenicol. If any of these effects persist or worsen, tell your doctor or pharmacist right away. Chloramphenicol injection may cause a condition called gray syndrome in premature babies and infants. There have also been reports of Gray’s syndrome in children up to 2 years of age and in infants whose mothers were treated with chloramphenicol during delivery.

Symptoms that usually occur after 3 to 4 days of treatment in some patients include stomach bloating, vomiting, blue lips and skin due to lack of oxygen in the blood, low blood pressure, difficulty breathing and death. If treatment is stopped at the first sign of any of the symptoms, the symptoms may disappear and the baby will recover completely. Talk to your doctor about the risks of using this medicine during labor or to treat infants and young children. This drug also causes other side effects, contact your doctor if you experience any unusual problems while taking this drug.

1. nightmares
2. Headache
3. urticaria
4. diarrhea
5. stomatitis
6. enterocolitis
7. nausea
8. Vomit
9. Bone marrow suppression
10. Aplastic anemia
11. Peripheral neuropathy
12. optic neuritis
13. Gray syndrome

Drug interaction of chloramphenicol

1. Interactions category X (avoidance): BST (intravesical), cholera vaccine, cladribine, dipyrone
2. Reducing the effects of drugs by chloramphenicol (systemic): BCG (intravesical), BCG vaccine (immunogenic), ceftazidime, cholera vaccine, lactobacillus and estriol, sodium picosulfate, typhoid vaccine, vitamin B12
3. Reducing the effects of chloramphenicol (systemic) by drugs: barbiturates, fosphenytoin, phenytoin, rifampin
4. Increased effects of drugs by chloramphenicol (systemic): alcohol (ethyl), barbiturates, carbocysteine, clozapine, cyclosporine (systemic), deferiprone, fosphenytoin, phenytoin, sulfonylureas, tacrolimus (systemic), vitamin K antagonist
5. Increased effects of chloramphenicol (systemic) by drugs: chloramphenicol (ophthalmic), cladribine, dipyrone, fosphenytoin, mesalamine, phenytoin, promazine.

Use of chloramphenicol during pregnancy and breastfeeding

The use of chloramphenicol during pregnancy is not recommended at all. This drug is in pregnancy safety category C, which means that there is evidence of risk to the fetus. Chloramphenicol is a broad-spectrum antibiotic used to treat various bacterial infections. The benefits of the drug against the possible risks determine whether or not to use it during pregnancy.

Chloramphenicol storage conditions

Chloramphenicol should be stored at room temperature and away from light. It is also important to keep all medications out of the reach of children, as many forms of medication (such as weekly tablets and eye drops, creams, patches, and inhalers) are not child-resistant and can be easily opened by young children. . Unnecessary medications should be disposed of in specific ways to ensure that pets, children, and other people cannot ingest them.

The last word of chloramphenicol drug

In this article from Darokhaneh Sabz Online Pharmacy, we investigated the drug chloramphenicol as an effective antibiotic from the group of tetracyclines. With a long history in the medical world, this drug has many effects in the treatment of bacterial infections. From its mechanism of action to medical applications, this medicine plays an important role in healing and treating many diseases. However, avoid over-the-counter and overdose of this drug to avoid serious side effects.

Site source: Medscape