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CHLORAMPHENICOL
(Chloromycetin®, Kemicetine®…)
Prescription under medical supervision
Indications
– Antibacterial
Dosage
– Typhoid fever, plague, rickettsial infections
– Parenteral to oral switch therapy (meningitis, severe pneumonia, etc.)
– 250 mg capsule
– Powder for oral suspension, 125 mg/5 ml
– Child from 2 months to 1 year: 50 mg/kg/day in 3 to 4 divided doses
– Child over 1 year: 50 mg/kg/day in 3 to 4 divided doses; 100 mg/kg/day in severe infection
– Adult: 3 to 4 g/day in 3 to 4 divided doses
Contra-indications, adverse effects, precautions
– Typhoid fever: 10 to 14 days; plague: 10 days; rickettsiosis: continue for 48 hours after the resolution of fever; pneumonia: 5 to 10 days
Remarks
– Do not administer to premature infants; avoid in newborns and children under 2 months of age (if there is no alternative, dosage is 25 mg/kg/day in 3 divided doses).
– Do not administer to patients with a history of previous allergic and/or toxic reaction to chloramphenicol, G6PD deficiency.
– Reduce dosage in patients with hepatic or renal impairment.
– May cause:
• gastrointestinal disorders,
• allergic reactions, dose-related and reversible marrow depression (anaemia, leucopenia,
thrombocytopenia): if so, stop treatment,
• grey syndrome in premature infants and neonates (vomiting, hypothermia, blue-grey
skin colour and cardiovascular depression), irreversible aplastic anaemia.
– Pregnancy: CONTRA-INDICATED, except if vital, if there is no therapeutic alternative. If used during
the 3rd trimester, risk of grey syndrome in the newborn infant.
– Breast-feeding: CONTRA-INDICATED
– Due to its potential haematotoxicity, the use of chloramphenicol should be restricted to
severe infections when other less toxic antibiotics are not effective or are contra-indicated.
– Oral treatment is more effective than parenteral treatment: blood and tissue concentrations
are higher when chloramphenicol is given orally.
– Storage: below 30°C –
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