Chloramphenicol Eye Ointment - Product information and Uses
Chloramphenicol is a bacteriostatic antimicrobial which is considered a prototypical broad-spectrum antibiotic, alongside the tetracyclines. Chloramphenicol is effective against a wide variety of Gram-positive and Gram-negative bacteria, including most anaerobic organisms. It is used topically for eye infections but due to resistance and safety concerns, it is no longer a first-line agent for any infection.
It is active against Gram-positive bacteria (including most strains of MRSA), Gram-negative bacteria and anaerobes. Chloramphenicol is mostly restricted to topical uses because of the worries about the risk of aplastic anaemia.
Chloramphenicol - Availability And Packaging
Chloramphenicol is available as Chloramphenicol Eye Ointment which is packaged in the form of aplicaps.
Side Effects of Chloramphenicol
The most serious side effect of chloramphenicol treatment is aplastic anaemia. This effect is rare and is generally fatal: there is no treatment and no way of predicting who may or may not get this side effect. The effect usually occurs weeks or months after chloramphenicol treatment has been stopped, and there may be a genetic predisposition.
Bone marrow suppression
Chloramphenicol commomly causes bone marrow suppression during treatment. This is due to a direct toxic effect of the drug on human mitochondria. This effect manifests first as a fall in hemoglobin levels, which occurs quite predictably once a cumulative dose of 20 g has been given. The anaemia is fully reversible once the drug is stopped and does not predict future development of aplastic anaemia.
There is an increased risk of childhood leukemia, and the risk increases with length of treatment.
Possible Related Adverse Effects
Chloramphenicol is particularly toxic to people sensitive to benzene-based preservatives. Chloramphenicol poisoning can cause sensitivity reactions to organic acids and salicylates. It is also known to cause tinnitus and balance problems through inner ear damage. It also causes folic acid depletion, resulting in adverse effects to the thyroid, pituitary and prostate through effects on PABA levels. There may also be links to chronic lymphocytic leukemia (CLL) through folic acid "depletion" and resultant high levels of folic acid in the mutant lymphocytes that characterize CLL. Chloramphenicol stops the body's production of vitamin D and pregnenolone resulting in major hormone depletion, including DHEA and testosterone, that can result in death and also lowers the body's resistance to viral infection. Chloramphenicol can also cause testes pain, possibly through hormone effects.
Gray baby syndrome
Intravenous chloramphenicol use has been associated with the so-called gray baby syndrome. This phenomenon occurs in newborn infants because they do not yet have fully functional liver enzymes (i.e. UDP-glucuronyl transferase), so chloramphenicol remains unmetabolized in the body. This causes several adverse effects, including hypotension and cyanosis. The condition can be prevented by using the drug at the recommended doses, and monitoring blood levels.
Chloramphenicol Eye Ointment - Dosage
Apply a small amount of the Chloramphenicol Eye ointment, to the affected eye every 3 hours or more frequently if necessary. Continue administration day and night for the first 48 hours, at which time the frequency of application can be decreased. Treatment should be continued for at least 48 hours after the eye appears normal.
Overdosage and Overdose Symptoms of Chloramphenicol Eye Ointment
Accidental ingestion of Chloramphenicol Eye Ointment is unlikely to cause any toxicity due to the low content of antibiotic. If accidentally ingested by infants or young children, a local Poisons Information Centre should be contacted.
If irritation, pain, swelling, lacrimation, or photophobia occur after undesired eye contact, the exposed eye(s) should be washed with large amounts of room temperature water for at least 15 minutes.
Additional Info: Prescribing Information