CHLORAMPHENICOL

Antibacterial Activity

Active against most of the vancomycin-resistant enteroccoci
Excellent coverage of both gram-positives and gram-negatives
Active against anaerobes

Pregnancy Risk Factor

Category C

Contraindication/Precaution

Hypersensitivity to chloramphenicol or any component
Use with caution in patients with impaired renal or hepatic function and in neonates
Use with caution in patients with glucose 6-phosphate dehydrogenase deficiency
Can cause reversible or irreversible bone marrow depression, leukopenia, aplastic anemia, toxic level in newborn ( grey baby syndrome)

Mechanism of Action

Inhibits protein synthesis by reversibly binding to 50S ribosomal subunits 

Pharmacodynamics/Kinetics

Metabolism: 
liver
Half-life: 
1.6-3.3 hours, change with liver (or renal) function.
Elimination: 
excreted  in urine

Dosage

Children: IV

> 28 days old: 15.5-25 mg/kg IV q6h (max 2-4 g/d)

Adults:  

PO: 125-200 mg q12h

Ophthalmic: 

Children/adults: 
1-2 drops q3-4h for 48 hours then
1-2 drops bid-qid

Dosage In Renal Failure

Creatinine clearance (ml/min):
<10: 100 q24h
10-50: 200 q24h
50-80: 200 q24h
Dialysis
Hemo: 125-250 mg
CAPD: 100 mg