Type of Medication: Antibiotic

Indications: Serious infections unresponsive to other antibiotics including Pseudomonas aeruginosa , H.influenzae , Staphylococcus aureus, S maltophilia and  B .cepacia

Side Effects: Blood dycrasias including reversible and irreversible aplastic anaemia, hypoplastic anaemia, thrombocytopenia, agranulocytosis, nausea, vomiting,glossitis, stomatitis, diarrhoea, erythema multiforme, optic and peripheral neuropathy. Monitor blood count before and periodically during treatment.

Full blood count is recommended at day 21 if course longer than 3 weeks.

Route of administration: Adult (Intravenous)

Dose:50 mg/kg daily in 4 divided doses. Avoid repeated courses and prolonged treatment. Monitor blood counts before and periodically during treatment.

Administration: Can be given as a bolus injection or an infusion in Glucose 5% or sodium chloridr 0.9%.

Route of administration: Adult (Oral)

Dose: 12.5‐25mg/kg QDS (usually 500mg). Max. 1g QDS. Reduce dose in hepatic or renal impairment. Usually use 500 mg tds or qds. Avoid repeated courses

Administration: Comes as 250 mg capsules

Route of administration: Paediatric (Intravenous)

Dose:Haemophilus epiglottis and pyogenic meningitis 50-100 mg/kg daily in divided doses(high dosages decreased as soon as clinically indicated). Infants under 2 weeks: 25 mg/kg daily in 4 divided doses, 2 weeks to 1 year 50 mg/kg daily in 4 divided doses.

Administration: Plasma concentration monitoring required in neonates and preferred in those under 4 years of age. Peak plasma concentation (approx 1 hour after infusion): 15-25 mg/litre; predose (trough) concentration should not exceed 15 mg/litre

Route of administration: Paediatric (Oral)

Dose:>1 month: 12.5 mg/kg qds. Over 1 year 25 mg/kg 6 hrly, up to 500 mg qds. (Max 4 gms/day).

Examples of some Drug Interactions

Interacting drug: Ciclosporin

possibly increases ciclosporin levels

Interacting drug: Phenobarbitone

metabolism of chloramphenicol enhanced

Interacting drug: Phenytoin

increased phenytoin plasma levels

Interacting drug: Rifampicin

lowers plasma concentration of chloramphenicol

Interacting drug: Sulphonylureas

sulphonylureas effect enhanced

Interacting drug: Tacrolimus

possibly increases tacrolimus levels

Interacting drug: Warfarin

increased INR