Chloramphenicol is primarily a bacteriostatic antimicrobial which binds to 505 subunct of the ribosome, thereby inhibiting bacterial protein synthesis. It is effective against a wide variety of gram-positive and gram- negative bacteria including most anaerobic organisms. Due to resistance and safety concerns, it is no longer a first –line agent for any indication in developed nations, although it is sometimes used topically for eye infections.
Adverse effects
Anemia- aplastic and hemolytic anemia is rare and generally fatal. It usually occurs in patients with low level of glucose-6- phosphate dehydrogenase (g6pd).other types of reversible anemia, which is apparently dose-related and occurs concomitantly with therapy.
Bone marrow suppression- it is common for chloramphenicol to cause bone marrow suppression during treatment; this is a direct toxic effect of the drug on human mitochondria. This effect manifests first ad a fall in hemoglobin level and occurs quite predictably once a cumulative dose of 20g has been given. This effect is fully reversible once the drug is stopped and does not predict future development of aplastic anemia.
Gray baby syndrome- intravenous chloramphenicol use has been associated with gray baby syndrome. This occurs in newborn infants because they do not have fully functional liver enzymes (ie udp-glucuronyl transferase), and so chloramphenicol remains unmetabolised in the body because of their inability to excrete the drug, which accumulate to levels that interfere with the function of mitochondria ribosomes.this leads to hypotension, depressed berating, poor feeding, cardiorascular collapse, cyanosis (hence the term “gray baby”)and death.
Adverse effects
Anemia- aplastic and hemolytic anemia is rare and generally fatal. It usually occurs in patients with low level of glucose-6- phosphate dehydrogenase (g6pd).other types of reversible anemia, which is apparently dose-related and occurs concomitantly with therapy.
Bone marrow suppression- it is common for chloramphenicol to cause bone marrow suppression during treatment; this is a direct toxic effect of the drug on human mitochondria. This effect manifests first ad a fall in hemoglobin level and occurs quite predictably once a cumulative dose of 20g has been given. This effect is fully reversible once the drug is stopped and does not predict future development of aplastic anemia.
Gray baby syndrome- intravenous chloramphenicol use has been associated with gray baby syndrome. This occurs in newborn infants because they do not have fully functional liver enzymes (ie udp-glucuronyl transferase), and so chloramphenicol remains unmetabolised in the body because of their inability to excrete the drug, which accumulate to levels that interfere with the function of mitochondria ribosomes.this leads to hypotension, depressed berating, poor feeding, cardiorascular collapse, cyanosis (hence the term “gray baby”)and death.