What is chloramphenicol?
Chloramphenicol is an active substance used to combat severe bacterial infections and thus belongs to the group of antibiotics. It is believed to interfere with the bacteria‘s protein synthesis, i.e. the production of proteins essential for survival. Chloramphenicol is therefore a bactericide. Better known trade names for chloramphenicol are Chloramsaar and Paraxin. It is available only on prescription and today, due to the numerous side effects, it is only a second-rate antibiotic.
Fields of application
There are two types of applications of chloramphenicol: local and systemic. – In the case of local application, the effect of the drug is limited to one place. Examples are the use of chloramphenicol for conjunctival/corneal infections, itching or skin infections.
- In systemic use, chloramphenicol is believed to inhibit infections that have caused symptoms throughout the body. These include typhoid, dysentery, diptheria and malaria. Chloramphenicol is also used for bacterial meningitis, i.e. meningitis.
The use of chloramphenicol during pregnancy and lactation is contraindicated. Among other things, the use of chloramphenicol by pregnant women can lead to Grey’s syndrome. This leads to respiratory distress and circulatory collapse in the unborn child, which can be fatal.
There is also a contraindication for infants and small children. A strict indication should also be given for diseases of the haematopoietic system such as leukaemia or advanced liver insufficiency, with careful consideration of benefits and risks. and medication during lactation
Intake, metabolism and excretion
Depending on the intended effect, chloramphenicol is taken orally or applied as a solution, ointment or cream to the eye or skin. The half-life of the drug is three hours. Chloramphenicol is metabolised in the liver. It is excreted in the urine. Chloramphenicol is partially dialysable.
Side effects
Above a certain dose of chloramphenicol the bone marrow is damaged. The consequences are a reduced production of white blood cells (leukopenia) and platelets (thrombopenia). In addition, chloramphenicol can also cause aplastic anaemia, regardless of the amount taken, so that the formation of all types of blood cells in the bone marrow is disturbed.
Since chloramphenicol can cause many undesirable effects in the blood count, this drug is currently only used as a second-choice antibiotic, i.e. if the patient cannot tolerate other antibiotics or if they do not work. Other known side-effects of chloramphenicol, which are less common, are diseases of the gastrointestinal tract, allergies, inflammation of peripheral nerves (neuritis) or the optic nerve. If chloramphenicol is administered to newborns under 4 months of age, they may be poisoned, which can sometimes have serious consequences.
Interactions
Chloramphenicol increases the effect of blood thinners (anticoagulants). The effect of phenobarbital, an anesthetic used in the treatment of epilepsy and preparation for anaesthesia, is also supported by chloramphenicol. If a patient undergoes chemotherapy, it should always be borne in mind that chloramphenicol may also interact with methotrexate. Enhancing effects of chloramphenicol have also been described for sulfonylurea derivatives (antidiabetics) and phenytoin (against epilepsy and cardiac arrhythmia).
