Chloromycetin

Chloramphenicol capsules are reserved for desperate cases in Pakistani infectious disease wards, from Aga Khan in Karachi to isolation units at Mayo Hospital Lahore, where docs pull them out for meningitis or typhoid when first-lines crash due to resistance. As a broad-spectrum antibiotic hitting the 50S ribosome to halt bacterial protein, it’s PMDC-restricted for toxicity fears like gray baby syndrome and aplastic anemia, only after cultures confirm need. Oral caps in 250-500mg from local generics cost PKR 100-200 per strip—strict script via hospital pharmacy—pulled from ID protocols, blood monitoring non-negotiable.

Ingredients

• Active Ingredient: Chloramphenicol (250mg or 500mg base).
• Excipients: Starch, magnesium stearate—label for full.

Drug Class

Broad-Spectrum Antibiotic (Ribosome Inhibitor).

How It Functions

Chloramphenicol binds bacterial 50S ribosomal subunit, blocking peptidyl transferase to stop protein synthesis and kill gram-positives, negatives, and some intracellular bugs. In Pakistan’s multi-drug resistant typhoid belts, it’s last-line, but docs swab first amid bone marrow suppression scares.

Common Applications

Local ID guidelines limit to:

• Serious infections unresponsive to others (meningitis, typhoid fever).
• Life-threatening bugs confirmed sensitive.

Dosage Form

Capsules swallowed whole, 50mg/kg/day divided, with water.

Potential Side Effects

Common: Nausea, vomiting, diarrhea, rash, appetite loss.

Serious from reports: Gray tongue, blood disorders (anemia, low WBC), neuro hits (headache, dizziness), optic neuritis. ER for fever, bruising, or confusion.

Key Warnings and Precautions

PMDC mandates:

• Blood: Weekly CBCs—marrow suppression risk.
• Babies: Gray syndrome deadly—avoid neonates.
• Liver/Kidney: Adjust doses, monitor.
• Pregnancy: Category C—crosses placenta.
• Alcohol: Liver hit—skip.

Shortest course; infants extreme caution.

When It’s Not Suitable (Contraindications)

Skip if:

• Allergy to chloramphenicol.
• Bone marrow depression history or aplastic anemia.
• Liver/kidney failure.
• Optic/peripheral neuritis.
• Unconfirmed infections.
• GI disorders severe.

Drug Interactions

Flag doc:

• Phenytoin—toxicity up.
• Warfarin—bleed risk.
• Rifampin—levels drop.
• Cyclosporine—spike.
• Live vaccines—ineffective.

Food Interactions

Watch:

• Dairy—binds, cuts absorption.
• High-fat—delays uptake.
• Grapefruit—possible level rise.
• Alcohol—liver strain.
• Caffeine—prolonged effects.

In Case of Overdose

GI upset, marrow issues—ER for supportive, blood work.

Missed Dose

Take soon unless near next; skip, no double—steady kill bugs.

Storage and Disposal

Room temp (15-30°C), dry, light-free, kid-proof. Pharmacy disposal.

Quick Tips

• Empty stomach if possible.
• Full course mandatory.
• Blood tests routine.

Doctor Review

ID specialists at NICVD or PIMS deploy chloramphenicol IV first for Salmonella typhi resistant to ceftriaxone, switching oral if stable, but halt on WBC drop per DRAP alerts—rare now with better options, typhoid vaccine push.

Laboratory Screening

Essential:

• CBC weekly for marrow.
• LFTs, renal.
• Cultures sensitivity.

This traces chloramphenicol’s rare rescue role in Pakistan—toxicity facts, ID doc only.

Disclaimer: This is product information only, not a prescription or diagnosis. Consult a qualified Pakistani doctor before using chloramphenicol capsules to ensure it’s safe. Seek immediate care for severe symptoms like bruising, fever, or confusion.