Grey baby syndrome from chloramphenicol — MRCPCH TAS MCQ

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HardPharmacologyGrey baby syndrome from chloramphenicolMRCPCH TAS

A preterm neonate treated for suspected sepsis becomes ashen, hypotensive and hypothermic with abdominal distension. Drug history includes a broad-spectrum antibiotic cleared by hepatic conjugation. Which drug is most likely responsible?

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Correct answer: A — Chloramphenicol

Chloramphenicol can cause grey baby syndrome because neonates have immature glucuronidation and reduced renal excretion. Amoxicillin can cause rash or diarrhoea but does not produce this classic circulatory collapse syndrome. The pearl is that developmental pharmacology is central to neonatal prescribing safety.

Reference: BNFc; Nelson Textbook of Pediatrics; RCPCH Theory examination syllabi