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Chloramphenicol

Chloramphenicol

Bacteriostatic, broad spectrum antibiotic and is highly active against Salmonella including S. typhi. In high doses, it can inhibit mammalian mitochondrial protein synthesis as well. Bone marrow cells are specially susceptible.

Indications

Enteric fever (Typhoid & Para typhoid), H.influenzae meningitis, Anaerobic infections, Intraocular infections, Urinary tract infection, Con- junctivitis, external ear infections.


Dosage

250-500 mg 6 hrly Max total dose 28 gm. Children : 25-50 mg/kg/day.


Contra-Indications

Hypersensitivity; trival infections or prophylaxis; pregnancy and lactation, concomitant use of penicillins; large doses in neonates; prolonged or frequent intermittant use of topical chloramphenicol due to possibility of hypersensitivity reaction, including bone marrow hypoplasia.


Special Precautions

Never use it for minor infections or those of undefined etiology. Avoid repeated courses. Daily dose not to exceed 2-3 gm; duration of therapy less than 2 to 3 weeks; total dose in a course less than 28 gm. Regular blood counts, concomitant use of anti coagulants, anti convulsants and sulphonylureas. Paediatrics: Reduced dose necessary. Pregnancy & Lactation: Contraindicated. Elderly: No special problem.


Side Effects

G.I. upsets, optic and peripheral neurites, dry mouth, allergic skin reactions. Gray baby syndrome,Supra infections. Bone marrow depression, aplastic anaemia, agranulocytosis, thrombocytopenia or pancytopenia.


Drug Interactions

Increase the effects of phenytoin, oral anticoagulants of oral hypoglycaemic agents. Paracetamol prolong the duration of action of chloramphenicol, diuretics, inhibit the antibacterial effects of penicillins.


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