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Chemical structure of Chloramphenicol
2-D structure of Chloramphenicol


Chloramphenicol is an ‘old’ broad-spectrum antibiotic, available in IV, oral and topical formulations.

Not prescribed routinely in the UK, oral Chloramphenicol is on occasions the only oral option for some patients with antibiotic resistant infections.

It can cause a number of potentially serious adverse effects including bone marrow suppression, aplastic anaemia and optic and peripheral neuropathy.

If the patient has renal or hepatic impairment, dose modification may be required. Most excretion is via the urine, but this decreases with declining renal function.

Chloramphenicol should not be used, therefore, to treat urinary tract infections in patients with a creatinine clearance <60 mL/minute.

Chloramphenicol can also prolong the elimination of certain drugs including anticonvulsants and anticoagulants, resulting in higher serum concentrations of, for example, warfarin.

Do you have any experience of prescribing oral Chloramphenicol? Please let us know in the comments below.

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Intravenous to Oral Switch: Within Outpatient Parenteral Antibiotic Therapy (IVOST)


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