chloramphenicol at a glance
Medicine class
Broad-spectrum antibacterial; usually bacteriostatic.
Main topical uses
Acute bacterial conjunctivitis and susceptible bacterial infection of the outer ear.
Systemic role
Oral treatment is reserved for typhoid fever or life-threatening infection when other antibiotics will not suffice.
Contact lenses
Do not wear contact lenses during eye treatment; wait at least 24 hours after the final application before restarting soft lenses.
What is chloramphenicol used for?
Licensed uses vary by formulation.
Eye drops and ointment: acute bacterial conjunctivitis in adults and children aged 2 years and over.
Ear drops: susceptible bacterial infection of the external ear in adults and children.
Oral capsules: typhoid fever and life-threatening infections when other antibiotics will not suffice.
How does chloramphenicol work?
Chloramphenicol binds to bacterial ribosomes and interferes with peptide-bond formation, stopping protein synthesis. This usually prevents susceptible bacteria from growing and spreading; it does not treat viral or fungal infections.
chloramphenicol preparations and strengths
Eye drops
Route: Ophthalmic
Strengths: 5 mg/mL, 0.5%, 0.5% w/v, 0.5% w/w
Eye ointment
Route: Ophthalmic
Strengths: 1.0% w/w, 1% w/w
How to take chloramphenicol
Follow the product leaflet and instructions from the prescriber or pharmacist.
Wash and dry your hands before and after applying eye or ear preparations.
Do not let the bottle or tube tip touch the eye, ear, skin or fingers, and do not share the product.
Apply eye drops or ointment inside the lower-eyelid pocket, then close the eye.
After applying ear drops, keep the affected ear facing upwards briefly.
Do not wear contact lenses during eye treatment.
Do not drive or operate machinery until any blurred vision has cleared.
Take oral capsules exactly as directed by the specialist prescribing team.
chloramphenicol side effects
Common or expected effects
- Temporary stinging, burning or irritation after eye application
- Brief blurred vision, particularly with eye ointment
- Mild stinging, irritation, burning or itching in the ear
Get urgent medical advice
- Swelling, breathing difficulty, widespread rash or collapse suggesting a severe allergic reaction
- Unusual bruising, recurrent infections, pronounced tiredness or weakness suggesting bone-marrow suppression
- Persistent or worsening eye pain, vision disturbance, light sensitivity or clouding
chloramphenicol in pregnancy
UK pregnancy information considers eye and ear preparations acceptable when clinically needed because systemic absorption is small. Some product information is more restrictive, so check with a pharmacist or prescriber. The selected oral capsules are contraindicated during pregnancy.
chloramphenicol interactions
Systemic chloramphenicol has clinically important interactions; topical products can still be absorbed in small amounts.
Bone-marrow-suppressing medicines
Avoid combining them because effects on blood-cell production may be additive. Examples include cytotoxic medicines, clozapine, carbamazepine and some immunosuppressants.
Warfarin and other anticoagulants
Systemic chloramphenicol can raise exposure and may require closer monitoring or adjustment.
Phenytoin and other anticonvulsants
Systemic chloramphenicol can alter exposure, requiring clinical and concentration monitoring where appropriate.
Common questions about chloramphenicol
Answers are fully visible for fast scanning and source review.
Does chloramphenicol treat viral conjunctivitis?
No. It acts against susceptible bacteria and does not treat viral or fungal eye infections.
Why is systemic chloramphenicol reserved for serious infections?
Systemic exposure can cause important toxicity, including reversible bone-marrow suppression and rare irreversible aplastic anaemia.
Can children use chloramphenicol?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.