Adult Dosing
Serious infections caused by susceptible organisms
- 50 mg/kg/day IV divided q6 hrs; Max: 100 mg/kg/day
Pediatric Dosing
Skin and soft-tissue infections and Intra-abdominal infections
- Child/infants> 2 wks: 50 mg/kg/day IV divided q6 hrs; Max: 4000 mg/day
- Neonates >7 days and >2 kg: 50 mg/kg/day IV divided q12 hrs
- Neonates birth–7 days or =< 2 kg: 25 mg/kg/day
CNS infections (including meningitis) and Bacteremia
- Child/infants> 2 wks: 50 mg/kg/day IV divided q6 hrs; Max: 100 mg/kg/day; 4000 mg/day
- Neonates >7 days and >2 kg: 50 mg/kg/day IV divided q12 hrs
- Neonates birth–7 days or =< 2 kg: 25 mg/kg/day
[Outline]
- Hospitalization of patient is recommended to facilitate appropriate studies and observation during therapy [US Black Box Warning]
- Monitor patients for serious and fatal blood dyscrasias such as aplastic anemia, thrombocytopenia, granulocytopenia and leukopenia during therapy [US Black Box Warning]
- Avoid use of chloramphenicol when less potentially dangerous agents are effective [US Black Box Warning]
- Perform adequate blood studies periodically during the therapy to detect early blood changes such as leukopenia, reticulocytopenia or granulocytopenia [US Black Box Warning]
- Do not use for cold, influenza, infections of throat or as a prophylactic agent to prevent bacterial infection [US Black Box Warning]
- For IV use only; not for IM use
- Hydrolyze chloramphenicol to its microbiologically active form while administering in patients
- Patients started on IV therapy should be changed to the oral form as soon as practicable
- Clostridium difficile associated diarrhea which may vary in severity from mild to fatal colitis, has been reported with use of all antibiotics: if suspected/confirmed, ongoing antibiotic use not directed against C.difficile may need to be discontinued. Maintain appropriate fluid and electrolyte levels, protein supplementation, along with antibiotics for C. difficile as needed
- Overgrowth of nonsusceptible organisms including fungi may occur; monitor patients carefully take appropriate measures
- Repeated courses of chloramphenicol treatment should be avoided if possible
- Baseline blood studies should be followed by periodic blood studies every two days during therapy. The drug should be discontinued upon appearance of reticulocytopenia, leukopenia, thrombocytopenia, anemia
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Hematologic disorder
- G6PD deficiency
- Bone marrow suppressants
Pregnancy Category:C
Breastfeeding: Possibly unsafe. Adverse reactions such as vomiting, excessive intestinal gas and falling asleep at the breast have been reported in breastfed infants whose mothers were taking oral chloramphenicol. An alternate drug is preferred to chloramphenicol during breastfeeding, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 20 December 2010).Manufacturer advises caution while administering to a nursing woman.
US Trade Name(s)
US Availability
chloramphenicol (generic)
- INJ: 100 mg/mL (1 mL vial)
Canadian Trade Name(s)
Canadian Availability
chloramphenicol (generic)
- PWDR for INJ: 1000 mg/vial
UK Trade Name(s)
UK Availability
Kemicetine
- PWDR for INJ: 1000 mg/vial
Australian Trade Name(s)
Australian Availability
chloromycetin (generic)
[Outline]