15th March 2024

Chloramphenicol

This potent agent works through inhibiting protein synthesis by binding to the ribosomal 50S subunit. It has a wide spectrum of activity against gram-positive, gram-negative and anaerobic bacteria.

The adverse effects preclude the widespread use of this drug. It can cause bone marrow toxicity, aplastic anaemia, optic neuritis and hypersensitivity reactions. If given to premature babies and those <2 weeks of age, there is a risk of grey baby syndrome. This occurs due to immature glucuronosyltransferase and presents with the neonate having an ashen grey colour, abdominal distension, pallid cyanosis and circulatory collapse. It is also known to inhibit the CYP2C19 and CYP3A4 isoenzymes, potentiating the effects of warfarin, clopidogrel and phenytoin.