CHLORAMPHENICOL SODIUM

Background and Date of Approval

Chloramphenicol sodium received FDA approval for medical use on 20 February 1959 for the treatment of severe systemic bacterial infections.

Uses

Chloramphenicol sodium is a broad-spectrum antibacterial used to treat severe systemic bacterial infections, including typhoid, meningitis, and other infections. Typically, it is considered when previous antibiotic treatments have proven ineffective, when oral chloramphenicol is not feasible, or when a high concentration of the medication is required in your bloodstream.

How is it administered?

Chloramphenicol sodium is available as a 1mg injection. It is given only in a hospital setup by a healthcare provider. It is infused directly into your veins by your physician. Your physician will decide the dosage and frequency of this injection based on the severity of your disease and other factors.

Side Effects

Chloramphenicol can cause some side effects like any other drug. Some of the serious side effects are severe allergic reactions such as red raised areas on your skin, which may look like spots or be several inches across, which cause itchiness, grey syndrome – usually in newborn or premature infants, where the skin appears grey, white blood cells counts can also drop, increasing the chance of infections and fever, and anemia (a low red blood cell count) that leave you feeling tired and lethargic. Seek medical attention immediately if any of these side effects occur.

Warnings

It is not recommended to take this medication if allergic to chloramphenicol. Furthermore, if you're pregnant or breastfeeding, do not take this medication without consulting your doctor. If you have a history of kidney or liver disease or are already taking medications that could lead to bone marrow depression, it is essential to inform your disease condition with your healthcare provider. The same applies to a cold, viral influenza, or throat infection. Tell your doctor if you have recently received a vaccination or scheduled for one.

Precautions

This injection carries a potential risk of causing bone marrow suppression and bleeding disorders, including various forms of anemia (a reduction in red blood cells), leucopenia (a decrease in white blood cells), and thrombocytopenia (a decrease in platelets). These conditions can weaken your immune system and, in some cases, even develop into leukemia (blood cancer). Therefore, it is crucial to let your doctor know if you have any history of these disorders before starting chloramphenicol treatment.

Word of Advice

During treatment, your doctor will order frequent blood tests to monitor liver and kidney function and assess your blood count, as chloramphenicol sodium injection can damage blood cells and cause bone marrow suppression. Hospitalisation will be required until recovery is achieved. There is a risk of overgrowth of non-susceptible organisms, which may lead to severe diarrhoea for several months following administration. Inform your doctor of any side effects occurring during or after treatment. This medication must not be used as prophylaxis against bacterial infections such as colds, influenza, or throat infections. Chloramphenicol sodium is for in-hospital use only, administered by your doctor. Always discuss any concerns with your doctor before receiving this medication.

References

Eramol (UK) Ltd, Electronic medicines compendium (EMC), [Revised on Mar 2022], [Accessed on 23rd Sept 2023], https://www.medicines.org.uk/emc/product/12869/smpc Fresenius Kabi USA, LLC, US Food and Drug Administration (FDA), [Revised on Dec 2019], [Accessed on 23rd Sep 2023], https://fda.report/DailyMed/aed29594-211d-49ef-813f-131975a8d0e3 Fusion Healthcare Pvt Ltd., [Revised on 2018] [Accessed on 19th Aug 2021], https://www.fusionhealthc.com/products/ KD Tripathi, Essentials of Medical Pharmacology, Antimicrobial drugs, 8th edition, 2019, 790-792 Camille E. Beauduy, Lisa G. Winston, Tetracyclines, Macrolides, Clindamycin, Chloramphenicol, Streptogramins, & Oxazolidinones, Lange’s Basic and Clinical Pharmacology, 14th Edition, 2018, 815-825.

Frequently Asked Questions

Is chloramphenicol indicated for children?

Chloramphenicol is administered to children only when other antibiotic treatments have proven ineffective. Your doctor will prescribe it after carefully evaluating the benefits versus the risks for the child.

What is most common side effect of chloramphenicol in children?

Gray baby syndrome, a life-threatening condition, is a significant concern. This risk emerges from the drug's heightened toxicity, making it challenging for the liver to metabolize and eliminate the medicine in premature infants.

What diet should I follow during the treatment with chloramphenicol?

Take a plant-based diet to boost your immunity. Avoid sugary foods, smoking, and alcohol to resume a healthy lifestyle.

Who should not take chloramphenicol?

Chloramphenicol is not suitable for everyone. To ensure it's safe for you, tell your doctor if you have ever had an allergic reaction to chloramphenicol or other medicine (or) if you or your family ever had a rare condition called aplastic anemia (when your bone marrow does not produce blood cells).

Can chloramphenicol cause diarrhea?

Yes, rarely, chloramphenicol can cause prolonged diarrhea due to the overgrowth of non-susceptible organisms.

Available Brands 1

Written By: Muskan Patel, M.Pharm

Reviewed By: Dr. Vishwa Patel, MBBS