CHLORAMPHENICOL injectable

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    Prescription under medical supervision

     

     
    The use of chloramphenicol should be restricted to severe infections when other less toxic antibacterials are not effective or contra-indicated.

     

    Therapeutic action

    • Phenicol antibacterial

    Indications

    • First-line treatment of plague meningitis
    • Alternative to first-line treatments of septicaemic plague
    • Severe typhoid fever if the strain is susceptible (recent drug susceptibility test)

    Forms and strengths, route of administration

    • 1 g powder for injection, to be dissolved in 10 ml of water for injection, for IV injection over 1 to 2 minutes

    Dosage

    • Child from 1 year to < 13 years: 25 mg/kg every 8 hours
    • Child ≥ 13 years and adult: 1 g every 8 hours

     

    Age

    Weight

    1 g vial
    (to be dissolved in 10 ml)

    1 to < 2 years

    10 to < 13 kg

    3 ml x 3

    2 to < 3 years

    13 to < 15 kg

    3.5 ml x 3

    3 to < 6 years

    15 to < 20 kg

    5 ml x 3

    6 to < 8 years

    20 to < 25 kg

    6 ml x 3

    8 to < 9 years

    25 to < 30 kg

    7 ml x 3

    9 to < 11 years

    30 to < 35 kg

    8 ml x 3

    11 to < 13 years

    35 to < 45 kg

    9 ml x 3

    ≥ 13 years and adult

    ≥ 45 kg

    10 ml x 3

     

    Duration

    • Plague: 10 days
    • Typhoid fever: 14 days

    ​​​​Change to oral route as soon as possible.

    Contra-indications, adverse effects, precautions

    • Do not administer to children under 1 year.
    • Do not administer to patients with:
      • history of allergic reaction or bone marrow depression during a previous treatment with chloramphenicol;
      • G6PD deficiency.
    • May cause:
      • dose-related haematological toxicity (bone marrow depression, anaemia, leucopenia, thrombocytopenia), allergic reactions. In these events, stop treatment immediately;
      • gastrointestinal disturbances, peripheral and optic neuropathies.
    • Reduce dosage in patients with hepatic or renal impairment.
    • Avoid or monitor combination with potentially haematotoxic drugs (carbamazepine, co-trimoxazole, flucytocine, pyrimethamine, zidovudine, etc.).
    • Pregnancy: CONTRA-INDICATED, except if vital, if there is no therapeutic alternative. If used during the 3rd trimester, risk of grey syndrome in the neonate (vomiting, hypothermia, blue-grey skin colour and cardiovascular depression).
    • Breast-feeding: CONTRA-INDICATED

    Remarks

    • Oral treatment is more effective than parenteral treatment: blood and tissue concentrations are higher when chloramphenicol is given orally.

    Storage

     
    – Below 25 °C