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Chloramphenicol
Systematic (IUPAC) name
2,2-dichlor-N- [(aR,bR)-b-hydroxy-a-hydroxymethyl- 4-nitrophenethyl] acetamide
Identifiers
CAS number 56-75-7
ATC code D06AX02 D10AF03 G01AA05 J01BA01 S01AA01 S02AA01 S03AA08
PubChem 298
DrugBank EXPT00942
Chemical data
Formula C11H12Cl2N2O5 
Mol. mass 323. IUPAC Nomenclature is a system of naming Chemical compounds and of describing the science of Chemistry in general CAS registry numbers are unique numerical identifiers for Chemical compounds Polymers biological sequences mixtures and Alloys They are also referred to The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs It is controlled by the WHO Collaborating Centre for Drug A section of the Anatomical Therapeutic Chemical Classification System. A section of the Anatomical Therapeutic Chemical Classification System. A section of the Anatomical Therapeutic Chemical Classification System. A section of the Anatomical Therapeutic Chemical Classification System. A section of the Anatomical Therapeutic Chemical Classification System. A section of the Anatomical Therapeutic Chemical Classification System. A section of the Anatomical Therapeutic Chemical Classification System. PubChem is a Database of chemical Molecules The system is maintained by the National Center for Biotechnology Information (NCBI a component The DrugBank database available at the University of Alberta is a unique Bioinformatics and Cheminformatics resource that combines detailed drug (i A chemical formula is a way of expressing information about the Atoms that constitute a particular Chemical compound, and how the relationship between those atoms changes Carbon (kɑɹbən is a Chemical element with the symbol C and its Atomic number is 6 Hydrogen (ˈhaɪdrədʒən is the Chemical element with Atomic number 1 Chlorine (ˈklɔriːn from the Greek word 'χλωρóς' ( khlôros, meaning 'pale green' is the Chemical element with Atomic number 17 and Nitrogen (ˈnaɪtɹəʤɪn is a Chemical element that has the symbol N and Atomic number 7 and Atomic weight 14 Oxygen (from the Greek roots ὀξύς (oxys (acid literally "sharp" from the taste of acids and -γενής (-genēs (producer literally begetteris the The molecular mass (abbreviated m of a substance, more commonly referred to as molecular weight and abbreviated as MW, is the Mass of one 132 g/mol
Pharmacokinetic data
Bioavailability 75–90%
Metabolism Hepatic
Half life 1. In Pharmacology, bioavailability is used to describe the fraction of an administered Dose of unchanged drug that reaches the Systemic circulation, one of Drug metabolism is the Metabolism of drugs, their Biochemical modification or degradation usually through specialized enzymatic systems The liver is a vital organ in the human body and is present in Vertebrates and some other animals The biological half-life of a substance is the time it takes for a substance (drug radioactive nuclide or other to lose half of its pharmacologic physiologic or radiologic activity 5–4. 0 hours
Excretion Renal
Therapeutic considerations
Pregnancy cat.

C (A topical)
Legal status

ocular P, else POM (UK)
Routes Topical (ocular), oral, IV, IM

Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae, isolated by David Gottlieb, and introduced into clinical practice in 1949. Excretion is the process of eliminating waste products of Metabolism and other non-useful materials The kidneys are complicated organs that have numerous biological roles The pregnancy category of a pharmaceutical agent is an assessment of the risk of fetal injury due to the pharmaceutical if it is used as directed by the mother during The regulation of therapeutic goods, that is drugs and therapeutic devices, varies by jurisdiction The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom, the UK or Britain,is a Sovereign state located In Pharmacology and Toxicology, a route In Medicine, a topical Medication is applied to body surfaces such as the Skin or Mucous membranes for example the Vagina Intravenous therapy or IV therapy is the giving of Liquid substances directly into a Vein. Intramuscular injection is the injection of a substance directly into a Muscle. Bacteriostatic Antibiotics limit the growth of bacteria by interfering with bacterial Protein production DNA replication or other aspects of An antimicrobial is a substance that kills or inhibits the growth of Microbes such as Bacteria, Fungi, or Viruses. The Bacteria ( singular: bacterium) are a large group of unicellular Microorganisms Typically a few Micrometres in length bacteria have Streptomyces venezuelae is a species of soil-dwelling Gram-positive Bacterium of the Genus Streptomyces. David Gottlieb (1911 &ndash 1982 a professor of plant pathology at the University of Illinois at Urbana-Champaign (1946-1982 was a pioneer in the field of fungi

It was the first antibiotic to be manufactured synthetically on a large scale. Chloramphenicol is effective against a wide variety of microorganisms; it is still very widely used in low income countries because it is exceedingly cheap, but has fallen out of favour in the West due to a very rare but very serious side effect: aplastic anemia.

In the West, the main use of chloramphenicol is in eye drops or ointment for bacterial conjunctivitis. Eye drops are saline -containing Drops used as a vector to administer medication in the Eye. An ointment is a viscous semisolid preparation used topically on a variety of body surfaces Conjunctivitis (commonly called " Pink Eye " or " Red Eye " in North America and " Madras eye " in India) is an inflammation

Chloramphenicol has recently been discovered to be a life saving cure for chytridiomycosis in amphibians. Chytridiomycosis is an Infectious disease of Amphibians, caused by the Chytridaceous fungus Batrachochytrium dendrobatidis. [1] Chytridiomycosis is a fungal disease that has been blamed for the extinction of one-third of the 120 frog species lost since 1980.

Contents

Dosage

The usual dose is 50 mg/kg/day in four divided doses: the usual dose in an adult male is therefore around 750 mg four times daily; this dose is doubled in severe illness. Half the dose is used in premature babies or neonates, because they do not metabolise the drug as effectively.

Chloramphenicol is available as 250 mg capsules or as a liquid (125 mg/5 ml). In some countries, chloramphenicol is sold as chloramphenicol palmitate ester. Palmitic acid,CH3(CH214COOH or hexadecanoic acid in IUPAC nomenclature, is one of the most common saturated Fatty acids found in animals Esters are a class of Chemical compounds and Functional groups Esters consist of an inorganic or organic Acid in which at least Chloramphenicol palmitate ester is inactive, and is hydrolysed to active chloramphenicol in the small intestine. Hydrolysis is a Chemical reaction during which one or more water molecules are split into hydrogen and hydroxide ions which may go on to participate in further reactions In Biology the small Intestine is the part of the Gastrointestinal tract (gut between the Stomach and the Large intestine, and comprises There is no difference in bioavailability between chloramphenicol and chloramphenicol palmitate. In Pharmacology, bioavailability is used to describe the fraction of an administered Dose of unchanged drug that reaches the Systemic circulation, one of

The intravenous (IV) preparation of chloramphenicol is the succinate ester, because pure chloramphenicol does not dissolve in water. Succinic acid ( IUPAC Systematic name: butanedioic acid; historically known as spirit of amber) is a Dicarboxylic acid. Esters are a class of Chemical compounds and Functional groups Esters consist of an inorganic or organic Acid in which at least This creates a problem: chloramphenicol succinate ester is an inactive prodrug and must first be hydrolysed to chloramphenicol; the hydrolysis process is incomplete and 30% of the dose is lost unchanged in the urine, therefore serum concentrations of chloramphenicol are only 70% of those achieved when chloramphenicol is given orally. A prodrug is a pharmacological substance ( drug) that is administered in an inactive (or significantly less active form [2] For this reason, the chloramphenicol dose needs to be increased to 75 mg/kg/day when administered IV in order to achieve levels equivalent to the oral dose. [3] The oral route is therefore preferred to the intravenous route.

Manufacture of oral chloramphenicol in the U. S. stopped in 1991, because the vast majority of chloramphenicol-associated cases of aplastic anaemia are associated with the oral preparation. There is now no oral formulation of chloramphenicol available in the U. S.

Dose monitoring

Plasma levels of chloramphenicol must be monitored in neonates and in patients with abnormal liver function. Blood plasma is the Liquid component of Blood, in which the Blood cells are suspended It is recommended that plasma levels be monitored in all children under the age of 4, the elderly and patients with renal failure. Peak levels (1 hour after the dose is given) should be 15–25 mg/l; trough levels (taken immediately before a dose) should be less than 15 mg/l.

Chloramphenicol and the liver

Chloramphenicol is metabolised by the liver to chloramphenicol glucuronate (which is inactive). Glucuronic acid (from Greek γλυκερός - "sweet" is a Carboxylic acid. In liver impairment, the dose of chloramphenicol must therefore be reduced. There is no standard dose reduction for chloramphenicol in liver impairment, and the dose should be adjusted according to measured plasma concentrations.

Chloramphenicol and the kidneys

The majority of the chloramphenicol dose is excreted by the kidneys as the inactive metabolite, chloramphenicol glucuronate. Only a tiny fraction of the chloramphenicol is excreted by the kidneys unchanged. It is suggested that plasma levels be monitored in patients with renal impairment, but this is not mandatory. Chloramphenicol succinate ester (the inactive intravenous form of the drug) is readily excreted unchanged by the kidneys, more so than chloramphenicol base, and this is the major reason why levels of chloramphenicol in the blood are much lower when given intravenously than orally.

Oily chloramphenicol

Dose: 100 mg/kg (maximum dose 3 g) as a single intramuscular injection. The dose is repeated if there is no clinical response after 48 hours. A single injection costs approximately US$5. The United States dollar ( sign: $; code: USD) is the unit of Currency of the United States; it has also been

Oily chloramphenicol (or chloramphenicol oil suspension) is a long-acting preparation of chloramphenicol first introduced by Roussel in 1954; marketed as Tifomycine, it was originally used as a treatment for typhoid. Typhoid fever, also known as enteric fever, bilious fever, Yellow Jack or commonly just typhoid, is an illness caused by the Bacterium Roussel stopped production of oily chloramphenicol in 1995; the International Dispensary Association has manufactured it since 1998, first in Malta and then in India from December 2004. Malta, officially the Republic of Malta (Repubblika ta' Malta is a European Microstate, comprising an Archipelago of three islands India, officially the Republic of India (भारत गणराज्य inc-Latn Bhārat Gaṇarājya; see also other Indian languages) is a country

Oily chloramphenicol is recommended by the World Health Organization (WHO) as the first line treatment of meningitis in low-income countries and appears on the essential drugs list. Meningitis is Inflammation of the protective membranes covering the Brain and Spinal cord, known collectively as the Meninges. Essential medicines, as defined by the World Health Organization are "those drugs that satisfy the health care needs of the majority of the population they should therefore It was first used to treat meningitis in 1975[4] and there have been numerous studies since demonstrating its efficacy. [5][6][7] It is the cheapest treatment available for meningitis (US$5 per treatment course, compared to US$30 for ampicillin and US$15 for five days of ceftriaxone). Ampicillin is a beta-lactam Antibiotic that has been used extensively to treat bacterial Infections since 1961 Ceftriaxone ( INN) (ˌsɛftraɪˈæksoʊn/ /ˌkɛf- is a third-generation Cephalosporin Antibiotic. It has the great advantage of requiring only a single injection, whereas ceftriaxone is traditionally given daily for five days. This recommendation may yet change now that a single dose of ceftriaxone (cost US$3) has been shown to be equivalent to one dose of oily chloramphenicol. [8]

Oily chloramphenicol is not currently available in the U. S. or Europe.

Chloramphenicol eye drops

In the West, chloramphenicol is still widely used in topical preparations (ointments and eye drops) for the treatment of bacterial conjunctivitis. An ointment is a viscous semisolid preparation used topically on a variety of body surfaces Eye drops are saline -containing Drops used as a vector to administer medication in the Eye. Conjunctivitis (commonly called " Pink Eye " or " Red Eye " in North America and " Madras eye " in India) is an inflammation Isolated cases report of aplastic anaemia following chloramphenicol eyedrops exist, but the risk is estimated to be less than 1 in 224,716 prescriptions. [9] Note. http://www.patient.co.uk/showdoc/40025037/ suggests that the link between chloramphenicol eye drops and aplastic anemia is "not well founded".

Pharmacokinetics

Chloramphenicol is extremely lipid soluble, it remains relatively unbound to protein and is a small molecule: it has a large apparent volume of distribution of 100 litres and penetrates effectively into all tissues of the body, including the brain. A drug's efficiency may be affected by the degree to which it binds to the proteins within Blood plasma. The volume of distribution (VD, also known as apparent volume of distribution, is a pharmacological term used to quantify the distribution The concentration achieved in brain and cerebrospinal fluid (CSF) is around 30 to 50% even when the meninges are not inflamed; this increases to as high as 89% when the meninges are inflamed. Cerebrospinal fluid ( CSF) Liquor cerebrospinalis, is a clear Bodily fluid that occupies the Subarachnoid space and the Ventricular system

Chloramphenicol increases the absorption of iron. Human iron metabolism is the set of chemical reactions maintaining Human homeostasis of Iron. [10]

Uses

Because it functions by inhibiting bacterial protein synthesis, chloramphenicol has a very broad spectrum of activity: it is active against Gram-positive bacteria (including most strains of MRSA), Gram-negative bacteria and anaerobes. Proteins are large Organic compounds made of Amino acids arranged in a linear chain and joined together by Peptide bonds between the Carboxyl Gram-positive bacteria are those that are stained dark blue or violet by Gram staining. Gram-negative bacteria are those Bacteria that do not retain Crystal violet dye in the Gram staining protocol An anaerobic organism is any Organism that does not require Oxygen for growth and may even die in its presence [11] It is not active against Pseudomonas aeruginosa or Enterobacter species. Pseudomonas aeruginosa is a Gram-negative, aerobic, rod-shaped Bacterium with unipolar motility. Enterobacter is a genus of common Gram-negative, facultatively-anaerobic, rod-shaped Bacteria of the family Enterobacteriaceae It has some activity against Burkholderia pseudomallei, but is no longer routinely used to treat infections caused by this organism (it has been superseded by ceftazidime and meropenem). Burkholderia pseudomallei is a Gram-negative, bipolar Aerobic, Motile rod-shaped Bacterium. Ceftazidime ( INN) (sɛfˈtæzɨdiːm/ /kɛf- is a third-generation Cephalosporin Antibiotic. Meropenem is an ultra-broad spectrum injectable Antibiotic used to treat a wide variety of infections including Meningitis and Pneumonia. In the West, chloramphenicol is mostly restricted to topical uses because of the worries about the risk of aplastic anaemia.

The original indication of chloramphenicol was in the treatment of typhoid, but the now almost universal presence of multi-drug resistant Salmonella typhi has meant that it is seldom used for this indication except when the organism is known to be sensitive. Typhoid fever, also known as enteric fever, bilious fever, Yellow Jack or commonly just typhoid, is an illness caused by the Bacterium Salmonella enterica is a rod shaped Flagellated Gram-negative Bacterium, and a member of the Genus Salmonella Chloramphenicol may be used as a second-line agent in the treatment of tetracycline-resistant cholera. This article deals with the specific antibiotic called tetracycline Cholera, sometimes known as Asiatic cholera or epidemic cholera, is an infectious Gastroenteritis caused by the Bacterium

Because of its excellent CSF penetration (far superior to any of the cephalosporins), chloramphenicol remains the first choice treatment for staphylococcal brain abscesses. Cerebrospinal fluid ( CSF) Liquor cerebrospinalis, is a clear Bodily fluid that occupies the Subarachnoid space and the Ventricular system The cephalosporins (ˌsɛfələˈspɔrən/ /ˌkɛfə- are a class of β-lactam antibiotics. Staphylococcus aureus (ˌstæfɨləˈkɒkəs ˈɔriəs literally "Golden Cluster Seed" and also known as golden staph) is the most common cause of Brain abscess (or cerebral abscess is an Abscess caused by inflammation and collection of infected material coming from local (ear infection Dental abscess, infection It is also useful in the treatment of brain abscesses due to mixed organisms or when the causative organism is not known.

Chloramphenicol is active against the three main bacterial causes of meningitis: Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae. Meningitis is Inflammation of the protective membranes covering the Brain and Spinal cord, known collectively as the Meninges. Neisseria meningitidis, also simply known as meningococcus, is a heterotrophic Gram-negative diplococcal Bacterium best known for Streptococcus pneumoniae, or pneumococcus, is a Gram-positive, alpha-hemolytic diplococcus aerotolerant anaerobe and a member of the Genus Haemophilus influenzae, formerly called Pfeiffer's bacillus or Bacillus influenzae, is a non-motile Gram-negative Coccobacillus In the West, chloramphenicol remains the drug of choice in the treatment of meningitis in patients with severe penicillin or cephalosporin allergy and GPs are recommended to carry intravenous chloramphenicol in their bag. Penicillin (sometimes abbreviated PCN or pen) is a group of Beta-lactam antibiotics used in the treatment of Bacterial Infections The cephalosporins (ˌsɛfələˈspɔrən/ /ˌkɛfə- are a class of β-lactam antibiotics. A general practitioner, or GP is a medical practitioner who provides Primary care and specializes in Family medicine. In low income countries, the WHO recommend that oily chloramphenicol be used first-line to treat meningitis. Meningitis is Inflammation of the protective membranes covering the Brain and Spinal cord, known collectively as the Meninges.

Chloramphenicol has been used in the U. S. in the initial empirical treatment of children with fever and a petechial rash, when the differential diagnosis includes both Neisseria meningitidis septicaemia as well as Rocky Mountain spotted fever, pending the results of diagnostic investigations. Empirical treatment is a medical treatment not derived from the scientific method but derived from observation survey or common use Purpura (from the Latin purpura, meaning "purple" is the appearance of red or purple discolorations on the Skin, caused by Bleeding underneath A differential diagnosis (sometimes abbreviated DDx, ddx Neisseria meningitidis, also simply known as meningococcus, is a heterotrophic Gram-negative diplococcal Bacterium best known for Sepsis is a serious medical condition characterized by a whole-body inflammatory state (called a Systemic inflammatory response syndrome or SIRS caused Rocky Mountain spotted fever is the most severe and most frequently reported Rickettsial illness in the United States.

Chloramphenicol is also effective against Enterococcus faecium, which has led to it being considered for treatment of vancomycin-resistant enterococcus. Enterococcus faecium is a Gram positive Bacterium in the genus Enterococcus. Vancomycin-resistant enterococcus (VRE is the name given to a group of bacterial species of the genus Enterococcus that is resistant

Although unpublished, recent research suggests that chloramphenicol could also be applied to frogs to prevent their widespread destruction from fungal infections. [12]

Adverse effects

Aplastic anemia

The most serious side effect of chloramphenicol treatment is aplastic anaemia. An adverse drug reaction (abbreviated ADR) or adverse drug event (abbreviated ADE) is an expression that describes the unwanted negative consequences [13] This effect is rare and is generally fatal: there is no treatment and there is 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. [14] It is not known whether monitoring the blood counts of patients can prevent the development of aplastic anaemia, but it is recommended that patients have a blood count checked twice weekly while on treatment. A complete blood count ( CBC) also known as full blood count ( FBC) or full blood exam ( FBE) or blood panel, is The highest risk is with oral chloramphenicol[15] (affecting 1 in 24,000–40,000)[16] and the lowest risk occurs with eye drops (affecting less than 1 in 224,716 prescriptions). [9] At least one internet medical source suggests that the link between chloramphenicol eye drops and aplastic anemia is "not well founded". [17]

Thiamphenicol is a related compound with a similar spectrum of activity that is available in Italy and China for human use, and has never been associated with aplastic anaemia. Thiamphenicol is an Antibiotic. It is the Methyl - Sulfonyl analogue of Chloramphenicol and has a similar spectrum of activity but is 2 Thiamphenicol is available in the U. S. and Europe as a veterinary antibiotic, and is not approved for use in humans. Veterinary medicine the application of medical, diagnostic, and therapeutic principles to companion, domestic, exotic, wildlife

Bone marrow suppression

It is common for chloramphenicol to cause bone marrow suppression during treatment: this is a direct toxic effect of the drug on human mitochondria. Bone marrow suppression or myelotoxicity (adjective myelotoxic) is a serious side-effect of Chemotherapy and certain drugs affecting the immune system In Cell biology, a mitochondrion (plural mitochondria) is a membrane-enclosed Organelle found in most eukaryotic cells. This effect manifests first as a fall in hemoglobin levels and occurs quite predictably once a cumulative dose of 20 g has been given. Hemoglobin ( also spelled haemoglobin and abbreviated Hb or Hgb) is the Iron -containing Oxygen -transport Metalloprotein This effect is fully reversible once the drug is stopped and does not predict future development of aplastic anaemia.

Leukemia

There is an increased risk of childhood leukemia as demonstrated in a Chinese case-controlled study,[18] and the risk increases with length of treatment. Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood Case-control is a type of Epidemiological Study design. Case-control studies are used to identify factors that may contribute to a medical condition by comparing subjects

Gray baby syndrome

Intravenous chloramphenicol use has been associated with the so called gray baby syndrome. Gray baby syndrome (also termed Gray or Grey syndrome) is a rare but serious side effect that occurs in newborn infants (especially premature babies following the [19] This phenomenon occurs in newborn infants because they do not yet have fully functional liver enzymes, and so chloramphenicol remains unmetabolized in the body. [20] This causes several adverse effects, including hypotension and cyanosis. In Physiology and Medicine, hypotension refers to an abnormally low Blood pressure. Cyanosis is a blue coloration of the Skin and mucous membranes due to the presence of deoxygenated Hemoglobin in Blood vessels near the skin surface The condition can be prevented by using chloramphenicol at the recommended doses and monitoring blood levels. [21][22][23]

Mechanism and resistance

Chloramphenicol is bacteriostatic (that is, it stops bacterial growth). Bacteriostatic Antibiotics limit the growth of bacteria by interfering with bacterial Protein production DNA replication or other aspects of It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit, preventing peptide bond formation. The Peptidyl transferase is an aminoacyltransferase ( and the primary Enzymatic function of the Ribosome which forms Peptide links between The 23S RRNA is a 2904 nt long component of the large prokaryotic subunit ( 50S)The ribosomal Peptidyl transferase activity resides in this rRNA While chloramphenicol and the macrolide class of antibiotics both interact with the 50S ribosomal subunit, chloramphenicol is not a macrolide. Furthermore, their mechanisms are slightly different. While chloramphenicol directly interferes with substrate binding, macrolides sterically block the progression of the growing peptide.

There are three mechanisms of resistance to chloramphenicol: reduced membrane permeability, mutation of the 50S ribosomal subunit and elaboration of chloramphenicol acetyltransferase. Antibiotic resistance is the ability of a Microorganism to withstand the effects of Antibiotics. It is easy to select for reduced membrane permability to chloramphenicol in vitro by serial passage of bacteria, and this is the most common mechanism of low-level chloramphenicol resistance. High level resistance is conferred by the cat-gene; this gene codes for an enzyme called chloramphenicol acetyltransferase which inactivates chloramphenicol by covalently linking one or two acetyl groups, derived from acetyl-S-coenzyme A, to the hydroxyl groups on the chloramphenicol molecule. History See also History of genetics The existence of genes was first suggested by Gregor Mendel (1822-1884 who in the 1860s studied inheritance Enzymes are Biomolecules that catalyze ( ie increase the rates of Chemical reactions Almost all enzymes are Proteins Chloramphenicol acetyltransferase (or CAT is a bacterial Enzyme that detoxifies the Antibiotic Chloramphenicol. In Organic chemistry, acetyl (ethanoyl is a Functional group, the Acyl of Acetic acid, with Chemical formula - C[[Oxygen Hydroxyl in Chemistry stands for a molecule consisting of an Oxygen atom and a Hydrogen atom connected by a Covalent bond. The acetylation prevents chloramphenicol from binding to the ribosome. Resistance-conferring mutations of the 50S ribosomal subunit are rare.

Chloramphenicol resistance may be carried on a plasmid that also codes for resistance to other drugs. One example is the ACCoT plasmid (A=ampicillin, C=chloramphenicol, Co=co-trimoxazole, T=tetracycline) which mediates multi-drug resistance in typhoid (also called R factors). Ampicillin is a beta-lactam Antibiotic that has been used extensively to treat bacterial Infections since 1961 Co-trimoxazole (abbreviated SXT TMP-SMX TMP-SMZ or TMP-sulfa is an Sulphonamide, Antibacterial combination of Trimethoprim and Sulfamethoxazole This article deals with the specific antibiotic called tetracycline R-factor is an old name for a Plasmid that codes for Antibiotic resistance.

Trade names

Chloramphenicol has a long history and therefore a multitude of alternative names in many different countries:

References

  1. ^ Chloramphenicol cures chytridiomycosis R. T. M. Poulter, J. N. Busby, P. J. Bishop, M. I. Butler, R. Speare, BBC News
  2. ^ Glazko AJ, Dill WA, Kinkel AW, et al. (1977). "Absorption and excretion of parenteral doses of chloramphenicol sodium succinate in comparison with per oral doses of chloramphenicol (abstract)". Clin Pharmacol Ther 21: 104.  
  3. ^ Bhutta Z, Niazi S, Suria A (Mar-Apr 1992). "Chloramphenicol clearance in typhoid fever: implications for therapy. ". Indian J Pediatr 59 (2): 213-9. PMID 1398851.  
  4. ^ Rey M, Ouedraogo L, Saliou P, Perino L (1976). "Traitement minute de la méningite cérébrospinale épidémique par injection intramusculaire unique de chloramphénicol (suspension huileuse)". Médecine et Maladies Infectieuses 6: 120–24.  
  5. ^ Wali S, Macfarlane J, Weir W, Cleland P, Ball P, Hassan-King M, Whittle H, Greenwood B (1979). "Single injection treatment of meningococcal meningitis. 2. Long-acting chloramphenicol. ". Trans R Soc Trop Med Hyg 73 (6): 698-702. PMID 538813.  
  6. ^ Puddicombe J, Wali S, Greenwood B (1984). "A field trial of a single intramuscular injection of long-acting chloramphenicol in the treatment of meningococcal meningitis. ". Trans R Soc Trop Med Hyg 78 (3): 399-403. PMID 6464136.  
  7. ^ Pécoul B, Varaine F, Keita M, Soga G, Djibo A, Soula G, Abdou A, Etienne J, Rey M (Oct 5 1991). "Long-acting chloramphenicol versus intravenous ampicillin for treatment of bacterial meningitis. ". Lancet 338 (8771): 862-6. PMID 1681224.  
  8. ^ Nathan N, Borel T, Djibo A, et al. (2005). "Ceftriaxone as effective as long-acting chloramphenicol in short-course treatment of meningococcal meningitis during epidemics: a randomised non-inferiority study". Lancet 366 (9482): 308–13. PMID 16039333.  
  9. ^ a b Lancaster T, Stewart AM, Jick H (1998). "Risk of serious haematological toxicity with use of chloramphenicol eye drops in a British general practice database". Brit Med J 316: 667. PMID 9522792.  
  10. ^ "Iron Supplements". Pill Book, The (12th revised ed. ). (2006). Ed. Harold M. Silverman, Pharm. D. (editor-in-chief). New York: Bantam Dell. pp. 593–596. ISBN 978-0-553-58892-7.  
  11. ^ Neu HC, Gootz TD (1996). Antimicrobial Chemotherapy:Antimicrobial Inhibitors of Ribosome Function. . In: Baron's Medical Microbiology (Baron S et al, eds. ), 4th ed. , Univ of Texas Medical Branch. (via NCBI Bookshelf) ISBN 0-9631172-1-1.  
  12. ^ Kim Griggs. "Frog killer fungus 'breakthrough'", BBC News, 30 October 2007.  
  13. ^ Rich M, Ritterhoff R, Hoffmann R (Dec 1950). "A fatal case of aplastic anemia following chloramphenicol (chloromycetin) therapy. ". Ann Intern Med 33 (6): 1459-67. PMID 14790529.  
  14. ^ Nagao T, Mauer A (1969). "Concordance for drug-induced aplastic anemia in identical twins. ". N Engl J Med 281 (1): 7-11. PMID 5785754.  
  15. ^ Holt R (1967). "The bacterial degradation of chloramphenicol". Lancet i: 1259.  
  16. ^ Wallerstein R, Condit P, Kasper C, Brown J, Morrison F (Jun 16 1969). "Statewide study of chloramphenicol therapy and fatal aplastic anemia. ". JAMA 208 (11): 2045-50. PMID 5818983.  
  17. ^ Antimicrobial Eye Preparations. Patient Information Publications http://www.patient.co.uk/.+Retrieved on 2008-05-31. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1279 BC - Rameses II (The Great (19th dynasty becomes pharaoh of Ancient Egypt.
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  20. ^ Piñeiro-Carrero V, Piñeiro E (2004). "Liver. ". Pediatrics 113 (4 Suppl): 1097-106. PMID 15060205.  
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  22. ^ Mulhall A, de Louvois J, Hurley R (1983). "Chloramphenicol toxicity in neonates: its incidence and prevention." (Scanned copy & PDF). Br Med J (Clin Res Ed) 287 (6403): 1424-7. PMID 6416440.  
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External links

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