Chloramphenicol or chloramphenicol is an antibiotic drug to treat a variety of serious bacterial infections, especially when the infectious disease does not improve with other drugs. This drug is available in the form of drops (eyes and ears), eye ointments, tablets, capsules, syrups, and injections.
Chloramphenicol works by killing the bacteria that cause infection, or slowing it down to stop its growth. This drug is effective in treating infections caused by S. typhi, H. influenzae, E. coli, C. psitacci, and various bacterial species Neisseria, Staphylococcus, Streptococcus, and Rickettsia.
Some examples of diseases caused by bacterial infections that can be treated with chloramphenicol are conjunctivitis, otitis externa, meningitis, typhoid fever, bubonic plague, anthrax, and ehrlichiosis. Chloramphenicol can only be used with a doctor's prescription.
Trademark chloramphenicol: Bufacetine, Cendo Fenicol, Chloramex, Chloramphenicol Palmitate, Cloramidina, Colsancetine, Erlamycetin, Hufamycetin, Licochlor, Novachlor, Otolin, Vanquin Plus.
What is Chloramphenicol?
| group | Antibiotics |
| Category | Prescription drugs |
| Benefit | Treating bacterial infections |
| Used by | Adults and children (above 2 years) |
| Chloramphenicol for pregnant and lactating women | Category C: Animal studies have shown adverse effects on the fetus, but there are no controlled studies in pregnant women. Drugs should only be used if the expected benefit outweighs the risk to the fetus. Chloramphenicol can be absorbed into breast milk. If you are breastfeeding, do not use this medicine without consulting your doctor first. |
| Drug form | Tablets, capsules, syrups, drops, ointments, and injections |
Precautions Before Using Chloramphenicol
- Do not use chloramphenicol if you have an allergy, especially to this drug.
- Please be careful if you or your family has a history of blood disorders, such as aplastic anemia, bone marrow disorders, kidney disease, and liver disease.
- Tell your doctor if you have had a recent injury, had surgery (including dental surgery), or treatment with radiotherapy and chemotherapy.
- Tell your doctor if you are taking any other medicines, especially medicines that can raise your blood pressure, herbal products, or supplements.
- Tell your doctor if you will be vaccinated, especially with live vaccines, such as typhoid, cholera, and BCG vaccines.
- Chloramphenicol can affect blood sugar test results. Therefore, consult the use of this drug if you have diabetes.
- If your vision becomes blurry after using chloramphenicol eye drops or ointment, do not drive until you can see clearly again.
- If you have an allergic reaction or overdose after using chloramphenicol, see your doctor immediately.
Dosage and Instructions for Use of Chloramphenicol
The dose of chloramphenicol will be adjusted according to the patient's condition. The following are general doses of chloramphenicol according to the dosage form:
Chloramphenicol drops
- Dosage of eye drops: 1 drop every 2 hours, for the first 2 days. After that, reduce the dose to 1 drop, 3-4 times per day, for 3 days.
- Dosage of ear drops: 3-4 drops, every 6-8 hours, for 1 week.
Chloramphenicol ointment
- Dosage: Once applied 4-5 times a day until the infection is cured, or as recommended by a doctor. Do not use the drug for more than 1 week, except on doctor's advice.
Oral chloramphenicol (tablets, capsules, syrup)
- Adults: 50 mg/kg per day, divided into 4 doses. In severe infections, the dose may be increased to 100 mg/kg per day.
- Children: 25-50 mg/kg per day, divided into 4 doses. In severe infections, the dose may be increased to 100 mg/kg per day.
The dose of injectable chloramphenicol will be adjusted to the patient's condition. Injectable chloramphenicol should only be given by a doctor or by a nurse under the supervision of a doctor.
How to Use Chloramphenicol Correctly
Follow your doctor's advice and read the information on the chloramphenicol package before starting to use it. The following is a guide on how to use chloramphenicol based on its dosage form:
Chloramphenicol drops and ointment
Wash your hands before using chloramphenicol drops or ointment for the eyes, and make sure the eyes are clean. Next, tilt your head back, pull the lower eyelid up to form a pocket with one hand, and drop or apply the medicine with the other hand.
After that, close your eyes for 1-2 minutes while rotating your eyeballs so that the medicine can seep into the area of infection. Wipe up any remaining patches of liquid or ointment around the eyes. You can re-drill the medicine if the first drop doesn't enter your eye completely.
The eyes may become more sensitive when using chloramphenicol. Therefore, keep your eyes away from sun exposure, for example by wearing sunglasses. Do not wear contact lenses during treatment with chloramphenicol eye drops.
To use chloramphenicol ear drops, tilt your head and put the drops into the infected ear. Remain in this position for 10 minutes for the medicine to absorb. If the position feels sore, please lie down.
Oral chloramphenicol (tablets, capsules, syrup)
Oral chlomramphenicol should be taken on an empty stomach, which is about 1-2 hours before meals. Take this medicine with a glass of water.
For chloramphenicol syrup, use the dose according to the spoon provided in the medicine package. Do not use tablespoons or teaspoons as the amounts may vary.
Make sure that there is sufficient time between one dose and the next. Try to use chloramphenicol regularly at the same time every day, for optimal benefits.
Use chloramphenicol (oral, ointment, drops) as directed by your doctor. Stopping the drug too soon can make the bacteria resistant so that the infection can occur again in the future.
If you forget to use chloramphenicol, it is advisable to do it immediately if the break with the next schedule of use is not too close. If it is close, ignore it and do not double the dose.
Discard chloramphenicol after the duration of treatment is complete. Don't save it for later use, even if it's left over.
Interaction of Chloramphenicol with Other Drugs
There are several interactions that may occur if you use chloramphenicol together with other medicines, namely:
- Decreased effectiveness of chloramphenicol in eradicating bacteria, when used with rifampicin and phenobarbital.
- Increased risk of fatal side effects, when used with drugs that suppress bone marrow function.
- Increased risk of side effects of phenytoin, ciclosporin, and tacrolimus.
- Decreased effectiveness of ceftazidime, cynacobalamin (vitamin B12), and some live vaccines, such as the BCG vaccine, cholera vaccine, and typhoid vaccine.
- Decreased effectiveness of other antibiotics, such as ceftriaxone, in treating bacterial infections.
- Increased risk of bleeding, when used with warfarin.
- Increased effect of sulfonylurea antidiabetic drugs, such as gliclazide, glipizide, or gliquidone, so that hypoglycemia can occur.
Chloramphenicol Side Effects and Dangers
Chloramphenicol may cause some of the following side effects:
- Dizzy
- Headache
- Nausea or vomiting
- Diarrhea
- Confusion or daze
- Ulcer
- A stinging sensation in the eyes or ears
- Blurred vision
The side effects of chloramphenicol above are mild and only occur briefly after using the drug. If these side effects are more severe or do not go away, consult a doctor immediately.
You are also advised to go to the doctor immediately if you experience an allergic drug reaction or serious side effects, such as:
- Easy bruising
- Easy to get infected
- Feeling very weak or tired
- Difficult to breathe
Long-term use of chloramphenicol can also cause aplastic anemia. Therefore, do regular checkups as recommended by your doctor.