What are the side effects and contraindications of chloramphenicol?

Generally, the side effects of chloramphenicol include bone marrow suppression, aplastic anemia, gray baby syndrome, allergic reactions, and gastrointestinal damage. Contraindications include: not recommended for individuals with drug allergies, those with impaired liver or kidney function, psychiatric patients, newborns, and pregnant women. Specific details are as follows:

I. Side Effects

1. Bone Marrow Suppression

The components contained in the drug are toxic to mitochondria. If the medication is not taken as prescribed by a physician or if the dosage is adjusted without guidance, it may suppress bone marrow hematopoietic function, leading to bone marrow suppression.

2. Aplastic Anemia

Chloramphenicol belongs to the amphenicol class of antibacterial and anti-inflammatory drugs. After administration, it primarily works by inhibiting bacterial protein synthesis, thereby eliminating bacteria. Improper use of the drug may lead to bone marrow hematopoietic failure, resulting in aplastic anemia.

3. Gray Baby Syndrome

Newborns typically lack uridine diphosphate glucuronyltransferase in the liver. If chloramphenicol is used blindly without following medical advice during treatment, it may increase the detoxification burden on the liver and excretion burden on the kidneys. In severe cases, this can trigger gray baby syndrome.

4. Allergic Reactions

If a patient is allergic to chloramphenicol, an allergic (hypersensitivity) reaction may occur, causing symptoms such as itching and erythema.

5. Gastrointestinal Damage

Chloramphenicol can irritate the gastrointestinal mucosa, causing mucosal injury and resulting in discomfort such as abdominal pain and diarrhea.

II. Contraindications

1. Not Recommended for Individuals with Drug Allergies

Patients who are allergic to chloramphenicol or any of its components should not use the drug, to avoid severe allergic reactions after administration. Without prompt treatment, such reactions could endanger life and health.

2. Not Recommended for Patients with Impaired Liver or Kidney Function

The drug is metabolized through the liver and kidneys. If a patient already has compromised liver or kidney function, use of the drug is not advised, as it may further increase the liver’s detoxification burden and impair renal excretion.

3. Contraindicated in Psychiatric Patients

Psychiatric patients using chloramphenicol may experience severe psychiatric reactions, posing risks to their health.

4. Contraindicated in Newborns

Newborns have rich mucosal vasculature and rapidly absorb medications. Using chloramphenicol may result in excessively high drug concentrations in the blood, leading to adverse reactions.

5. Contraindicated in Pregnant Women

Use of chloramphenicol during pregnancy may cause toxic effects on the fetus, affecting normal fetal development.

Patients should use chloramphenicol only under the guidance of a physician. If any adverse symptoms occur, they should seek immediate medical attention at a hospital.