CHLORAMPHENICOL oral

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

– Alternative to first-line treatments of bubonic plague
– Typhoid fever if the strain is susceptible (recent drug susceptibility test)
– Completion treatment following parenteral therapy with chloramphenicol

Forms and strengths

– 250 mg capsule

Dosage

– Child from 1 year to less than 13 years: 12.5 mg/kg 3 to 4 times daily; the dose should be doubled in severe infection (max. 3 g daily)
– Child ≥ 13 years and adult: 1 g 3 to 4 times daily

Age

Weight

250 mg capsule

1 to < 4 years

10 to < 17 kg

1 cap x 3

4 to < 9 years

17 to < 30 kg

2 cap x 3

9 to < 13 years

30 to < 45 kg

3 cap x 3

≥ 13 years and adult

≥ 45 kg

4 cap x 3

Duration

– Plague: 10 days; typhoid fever: 7 days

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.).
– PregnancyCONTRA-INDICATED, except if vital, if there is no therapeutic alternative. If used during the 3rd trimester, risk of grey syndrome in the newborn infant (vomiting, hypothermia, blue-grey skin colour and cardiovascular depression).
– Breast-feedingCONTRA-INDICATED

Remarks

– Oral treatment is more effective than parenteral treatment: blood and tissue concentrations are higher when chloramphenicol is given orally.
– Capsules can be opened and their content mixed into a spoon with food.
– Also comes in 150 mg/5 ml powder for oral suspension.
  Storage: below 25 °C -