Chloramphenicol

Generally prescribed to patients suffering from eye problems, Chloramphenicol is used to treat infections of the eye and surrounding areas.

Overview

When prescribed as an ophthalmic ointment or solution, Chloramphenicol is used to treat eye infections. As an antibiotic, Chloramphenicol helps to reduce the symptoms caused by bacterial infections and kills the bacteria causing the infection.

In most instances, Chloramphenicol solution or ointment provides quick relief from infections of the eye. The medicine is only suitable for treating bacterial infections, however, and will not provide relief if the patient is suffering from a viral and/or fungal infection.

Chloramphenicol works by inhibiting the protein synthesis of the bacterial cells. By disrupting the transfer of activated amino acids, the medicine prevents the bacteria from spreading. At the same time, Chloramphenicol acts on the bacteria cells which are present, thus eliminating the infection from the patient’s eye (or eyes).

Although eye infections can cause uncomfortable and irritating symptoms, they are often very receptive to treatment. Chloramphenicol can be used to treat the following types of eye infections:

  • Streptococcus
  • Staphylococcus aureus
  • Escherichia Coli
  • Klebsiella/Enterobacter
  • Haemophilus influenza
  • Neisseria
  • Moraxella lucunata

Symptoms of bacterial eye infections can include pain, discomfort, itching, swelling of the eyelids and/or discharge from the eye. With effective treatment, however, patients should notice a decrease in symptoms fairly quickly.

Once doctors have confirmed that the infection is bacterial in nature, Chloramphenicol can be prescribed for topical application. Providing patients follow their doctor’s instructions regarding the application of Chloramphenicol, the infection should be resolved swiftly.

Conditions Treated:

  • Bacterial infections of the eye

Type of Medicine:

  • Antibiotic ophthalmic solution/ointment

Side Effects:

When applying eye drop solution or ointment, patients may experience blurred vision for a few moments. This is extremely common, rarely lasts for longer than a few minutes and is not usually a cause for concern. Similarly, patients may experience some mild burning or stinging when they apply Chloramphenicol to the affected eye or eyes. In most instances, these mild side-effects do not cause patients any problems.

In some situations, however, patients may experience additional side-effects when using Chloramphenicol as a topical solution. If patients experience any of the following side-effects when using this medication, they should seek medical advice:

  • Pale skin
  • Unusual bleeding or bruising
  • Sore throat and fever
  • Unusual tiredness or weakness

Furthermore, if patients notice that their symptoms are worsening, despite using the medication as instructed, they should seek medical help. If the patient develops itching, redness, a skin rash, swelling or signs or irritation which were not present before using the medication, they should contact their doctor for advice and assistance.

Although it is rare for patients to experience an adverse reaction when using Chloramphenicol ointment or solution, it is possible. By taking swift action in the presence of any unusual or severe side-effects, patients can ensure that they are able to access effective treatment without any complications occurring.

Dosage:

In order to obtain a prescription for Chloramphenicol ointment, patients will need to consult their doctor, ophthalmologist or physician. Once a bacterial infection has been diagnosed, the patient may be prescribed Chloramphenicol.

As with all other medications, patients should receive specific treatment instructions for their medical practitioner. They will be told how to use the medication, how often to apply Chloramphenicol and what the appropriate strength of Chloramphenicol is.

In most instances, Chloramphenicol ophthalmic ointment should be applied every 3 hours, whereas Chloramphenicol ophthalmic solution should be applied at the rate of one drop every 1-4 hours.

Although these are standard dosing instructions, physicians will determine the patient’s dose based on the severity of their condition and their medical history. Patients should, therefore, adhere to their doctor’s instructions when using Chloramphenicol ophthalmic ointment or solution.

When using Chloramphenicol to treat eye infections, it’s important that patients administer the medication properly. Failure to do so could result in the infection continuing to worsen and the patient could inadvertently cause the infection to spread.

Before applying the solution or ointment, patients should wash their hands thoroughly. When applying Chloramphenicol, patients should ensure that the applicator does not come into contact with any other substances, including their eye. If it does, it could contaminate other surfaces and spread infection or it may transfer germs and foreign substances into the eye.

If using Chloramphenicol eye drops, patients should tilt their head back and gently lower their eyelid, creating a space for the drops. They should then administer the appropriate amount of Chloramphenicol and gently close their eye. Patients should try not to blink so that the medicine can be properly absorbed. If possible, patients should apply gentle pressure to the inner corner of the eye to ensure that the eye drops reach the infection. They should then repeat the process on their other eye if they have been advised to do so.

If patients are using Chloramphenicol ointment, they should tilt their head back and press gently on their lower eyelid, thus creating a space to apply the ointment. In most cases, a 1cm strip of Chloramphenicol ointment is enough, unless the patient has been advised otherwise by their doctor. Patients should then close their eye, refrain from blinking and gently press the inner corner of their eye to ensure that the ointment reaches the relevant areas. If necessary, patients should then repeat the application process on their other eye. Patients should then wipe the tip of the ointment tube with a clean tissue.

Following application, patients should close the medication tightly, store it in a secure location and wash their hands thoroughly. Failure to do so may cause the infection to spread to other people.

If patients miss a dose of Chloramphenicol, they should apply the eye drop solution or ointment as soon as they remember to do so. If the next dose is almost due, patients should miss the dose completely and continue with their treatment schedule. If patients are unsure how to proceed with treatment, they should seek medical advice from their doctor or pharmacist.

Potential Drug Interactions:

If patients are taking other medications, it may not be appropriate for them to use Chloramphenicol, even if they have a bacterial eye infection. If patients have recently used or received the following medicines, they will not normally be given Chloramphenicol solution or ointment:

  • Citalopram
  • Cholera vaccine, live
  • Voriconazole

If patients are taking the following medications, interactions may occur if they are also using Chloramphenicol:

  • Ceftazidime
  • Tolbutamide
  • Chlorpropamide
  • Cyclosporine
  • Tetanus Toxoid
  • Dicumarol
  • Fosphenytoin
  • Tacrolimus
  • Phenytoin
  • Rifapentine
  • Rifampin

This does not necessarily mean that Chloramphenicol won’t be prescribed in conjunction with above medications, however. A change of dose or specific advice regarding when to take the medication may mean that interactions can be avoided.

Before using Chloramphenicol, patients should inform their physician if they are using any additional medications. This includes over-the-counter treatments, supplements and/or vitamins.

If patients are concerned about the possibility of drug interactions occurring, they should contact their physician or pharmacist. In addition to this, patients should seek medical advice before taking any over-the-counter medications, supplements or vitamins whilst using Chloramphenicol eye drop solution and/or ointment.

Warnings:

When using Chloramphenicol eye drops and/or ointment, patients should notice a reduction in symptoms within a few days. If they do not, they should contact their doctor so that their treatment can be reviewed.

Currently, it is not known whether ophthalmic forms of Chloramphenicol can cause harm to an unborn fetus. Due to this, patients who are pregnant may not be prescribed Chloramphenicol solution or ointment.

Similarly, it is not known whether Chloramphenicol can be passed on to an infant via breastmilk when the mother has used the solution or eye drops topically. Patients should seek medical advice before breastfeeding if they are currently using Chloramphenicol or if they have used Chloramphenicol eye drops and/or ointments recently.

Before using Chloramphenicol, patients should tell their doctor if they have any known allergies or if they have experienced anaphylaxis in the past. Although it’s not common for patients to experience an allergic reaction when using Chloramphenicol, they should seek urgent medical help if they suspect that they are allergic to the medication.

Swelling of the eyes, face, throat and/or lips can indicate that the patient is experiencing an allergic reaction and this is often preceded by tingling of the aforementioned areas. In addition to this, patients may have trouble breathing and they may develop hives, welts and/or itching.

If an allergic reaction isn’t treated quickly, it may be fatal. It is essential that patients take swift action if they suspect that they are allergic to the medication and they should call 911 as quickly as possible.

Storage:

Although patients can store Chloramphenicol solution and ointment at home, it’s important to ensure that it’s not accessible to anyone else. Children and pets, in particular, can be harmed if they gain access to medications so it’s vital that Chloramphenicol is stored somewhere safe.

In addition to this, Chloramphenicol should usually be kept at room temperature and away from direct light, heat and moisture. Patients should read the manufacturer’s storage instructions to ensure that they are keeping their medication in an appropriate environment.

If patients are advised to stop using the medication, they can access suitable disposal options by contacting their pharmacist or their nearest medical clinic. Medications, such as Chloramphenicol ointment and solution, should not usually be thrown out with household waste.

Summary

Bacterial eye infections are not uncommon and they can affect people of any age. As they tend to spread quite easily, patients may develop an infection if someone in their family or circle of friends is currently receiving treatment.

Although bacterial infections are prevalent, patients must seek medical advice from a doctor, physician or ophthalmologist before attempting to treat the condition. Bacterial eye infections will only respond to antibiotic treatment so over-the-counter solutions are unlikely to be effective in reducing their symptoms. Conversely, patients should not attempt to treat viral and/or fungal eye infections with an antibiotic, such as Chloramphenicol.

Once Chloramphenicol has been prescribed, patients should feel their symptoms reduce within a few days of treatment. Although patients should consult their doctor or ophthalmologist if symptoms do not subside, this is rarely necessary.

In the vast majority of cases, Chloramphenicol will successfully rid the eye of infection and minimize the patient’s symptoms, whether it’s prescribed as an eye drop solution or an ointment.

Resources
Last Reviewed:
December 24, 2017
Last Updated:
December 22, 2017