chloramphenicol sodium succinate: clinical use

Prescribing considerations

• Reserve for serious susceptible infections where less toxic options are ineffective or contraindicated.
• Obtain microbiological samples and susceptibility results so treatment can be reviewed promptly.
• Avoid repeated courses and unnecessary exposure.
• Consider the product's sodium content when clinically relevant.

Contraindications and cautions

• Previous hypersensitivity or toxic reaction to chloramphenicol.
• Pregnancy and breastfeeding are listed as contraindications for the selected product.

Monitoring

• Obtain a baseline full blood count and repeat it frequently during treatment; discontinue for blood abnormalities attributable to chloramphenicol.
• Monitor serum concentrations particularly in neonates, premature infants, older people, hepatic or renal impairment, and interacting treatment.
• Watch for grey syndrome in neonates, superinfection, severe diarrhoea and neurological or visual toxicity.

Clinical pharmacology

Chloramphenicol sodium succinate is a parenteral prodrug that rapidly releases chloramphenicol. Active chloramphenicol inhibits bacterial protein synthesis, distributes widely including into cerebrospinal fluid, and the prodrug, active compound and metabolites are excreted in urine.

Formulation and product differences

• Freeze-dried powder requiring aseptic reconstitution before administration.
• Suitable for intravenous injection or infusion; intramuscular absorption may be slow and unpredictable.
• The selected formulation contains sodium and has no listed excipients.
• A correctly reconstituted solution is clear and yellowish.

Injection

Route: Parenteral

Strengths: 1 g