Chloramphenicol: A review

Chloramphenicol was the first truly broad-spectrum antibiotic that had excellent tissue penetration available for clinical use. It was the drug of choice for many serious infections, such as bacterial meningitis, epiglottitis, typhoid fever, and Rocky Mountain spotted fever, until better and safer alternatives became available. Almost immediately after becoming licensed, adverse effects were reported with its use, including bone marrow suppression, idiosyncratic aplastic anemia, and cardiovascular collapse (gray baby syndrome). Chloramphenicol is a valuable antimicrobial agent that presently has very limited indications for use in the United States due to potential adverse effects. Chloramphenicol is currently available only as a parenteral formulation and in limited supply in the United States. However, the drug continues to play a major role in the treatment of serious infections in developing countries and may be of great therapeutic benefit for the management of life-threatening drug-resistant infections or in persons who are allergic to penicillin. It is important, therefore, that we reacquaint ourselves with this potent antimicrobial.