CHLORAMPHENICOL

Broad spectrum antibacterial reserved for treatment of severe infections

Dosage Forms

Powder for injection

1g vial

Opthalmic ointment

1%

Eye drops

0.5%

Ear drops

5%

Capsule

250 mg

Uses

  • Meningitis
  • Septicaemia
  • Plague
  • Typhoid
  • Typhus fever
  • Bronchiolitis
  • Severe throat infection
  • Severe breast infection
  • Pre-referral treatment for pneumonia and possible serious bacterial infection (PSBI) in infants >1 week old
  • Severe pneumonia
  • Bacterial eye infection
  • Ophthalmia of the new born
  • Ear infections

Dose and Duration

Meningitis and septicaemia
Adult: 1 g IV every 6 hours for 14 days Once clinical improvement occurs, reduce dose to 500–750 mg orally every 6 hours to complete the course
Child:25 mg/kg every 6 hours for 14 days
Plague, typhoid, typhus fever, pneumonia, breast infection
Adult:500 mg IV every 6 hours for 7–10 days
Child:25 mg/kg per dose every 6 hours for 7–10 days
Bronchiolitis, throat infection
Child > 2 weeks:12.5 mg/kg every 6 hours for 5 days.
Pre-referral treatment for pneumonia and PSBI (in combination with benzyl penicillin) , throat infection
Child > 1 weeks:40 mg/kg IM single dose Child < 1 weeks:20 mg/kg IM single dose

Refer immediately

If referral not possible:Repeat dose every 12 hours for 5 days, then change to an appropriate oral antibiotic to complete 10 days treatment

Bacterial eye infections
Adult and child over 2 years: apply eye ointment 3–4 times daily for 7 days or once at night if eye drops are used during day
Adult and child >2 years:1 eye drop every 2 hours for 2 days then 1 drop every 4 hours for 3 more days
Ophthalmia of the new born
Neonate: Ophthalmia of the new born
Ear infections
Apply 2 drops of eye/ear drops into the ear every 8 hours for 14 days

Contraindications

  • Severe kidney disease
  • Severe liver disease

Side Effects

  • Dry mouth, stomach upset
  • Skin rash
  • Unclear or temporary loss of vision
  • Headache
  • Anaemia
  • Grey baby syndrome

Interactions

  • Phenobarbital (reduced effect of chloramphenicol)
  • Phenytoin (increased side effects of phenytoin)

Pregnancy

  • Do not use

Breastfeeding

  • Do not use

⚠️ Caution

  • Alternative to benzyl penicillin if secondary bacterial infection is suspected
  • Avoid repeated courses and prolonged use
  • Grey baby syndrome is most likely to occur in neonates