Worst Pills, Best Pills

An expert, independent second opinion on more than 1,800 prescription drugs, over-the-counter medications, and supplements

Drug Profile

Do NOT stop taking this or any drug without the advice of your physician. Some drugs can cause severe adverse effects when they are stopped suddenly.

Do Not Use Except In the Hospital [what does this mean?]
Generic drug name: chloramphenicol (klor am FEN i kole)
Brand name(s): CHLOROMYCETIN
GENERIC: not available FAMILY: Other Drugs for Bacterial Infection
Find the drug label by searching at DailyMed.

Alternative Treatment [top]

If needed (outside the hospital), take a less toxic antibiotic.

Safety Warnings For This Drug [top]

Antibiotic-Associated Diarrhea

Antibiotic-associated diarrhea (AAD) is quite common and its incidence varies from 5% to 20% of patients depending on which antibiotic they are taking, although practically all antibiotics have been associated with AAD. Fortunately, most cases are mild and self-limited, ending with the cessation of use of the offending antibiotic. The antibiotics most commonly associated with this mild form of AAD include ampicillin, amoxicillin, cephalosporins and clindamycin.[1] There have been studies in children or adults in which the use of prophylactic yogurt in people using antibiotics has significantly reduced the occurrence or severity of AAD.[2],[3] However, 10% to 20% of all patients who get AAD (0.5% to 4% of patients using antibiotics) will get the more severe form of AAD known as pseudomembranous colitis (see below). If you are taking any antibiotic and develop diarrhea after starting to use the drug, call your physician to discuss whether another antibiotic should be used and to discuss the need for rehydration due to the fluid loss from the diarrhea.

Pseudomembranous colitis has been reported with nearly all antibacterial agents and may range in severity from mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea subsequent to the administration of antibacterial agents.

Because antibiotic therapy has been associated with severe colitis, which may end fatally, it should be reserved for serious infections where less toxic antimicrobial agents are inappropriate, as described in the INDICATIONS AND USAGE section. It should not be used in patients with nonbacterial infections such as most upper respiratory tract infections. Treatment with antibacterial agents alters the normal flora of the colon and may permit over-growth of clostridia. Studies indicate that a toxin produced by Clostridium difficile is one primary cause of "antibiotic-associated colitis."

After the diagnosis of pseudomembranous colitis has been established, therapeutic measures should be initiated. Mild cases of pseudomembranous colitis usually respond to drug discontinuation alone. In moderate to severe cases, consideration should be given to management with fluids and electrolytes, protein supplementation, and treatment with an antibacterial drug that is clinically effective against C. difficile colitis.

Diarrhea, colitis, and pseudomembranous colitis have been observed to begin up to several weeks following cessation of therapy.

Facts About This Drug [top]

Although chloramphenicol is effective in treating many conditions, it should be used only in a very limited number of situations because it is so dangerous. It can cause an irreversible depression of the bone marrow (where blood cells and platelets are produced), which usually results in death. It can also cause less serious reversible bone marrow depression.

Chloramphenicol should be used to treat serious diseases for which there is no better antibiotic available. Most of these diseases...

Although chloramphenicol is effective in treating many conditions, it should be used only in a very limited number of situations because it is so dangerous. It can cause an irreversible depression of the bone marrow (where blood cells and platelets are produced), which usually results in death. It can also cause less serious reversible bone marrow depression.

Chloramphenicol should be used to treat serious diseases for which there is no better antibiotic available. Most of these diseases require hospital treatment, so there is rarely any reason to take chloramphenicol at home. The only exception is that you may need to take it at home to finish treatment that was begun in the hospital. The oral use of the drug almost always provides excellent blood levels, and intravenous or injected use of chloramphenicol only needs to be used if the intestines are not working or if the patient is comatose.

Oral chloramphenicol (taken by mouth) is usually prescribed inappropriately to treat trivial infections.[4] Chloramphenicol should not be used for minor infections, and it will not help a cold or the flu.

last reviewed April 30, 2021