Using the microbiological assay method, the average peak serum level was 11.2 mcg/mL one hour after the first dose. The following summarizes the clinical and laboratory studies that have been made on these patients:a) In most cases therapy with chloramphenicol had been instituted within the first 48 hours of life.b) Symptoms first appeared after 3 to 4 days of continued treatment with high doses of chloramphenicol. 2002 If infections caused by nonsusceptible organisms appear during therapy, appropriate measures should be taken.Baseline blood studies should be followed by periodic blood studies approximately every two days during therapy. Individual plans may vary Enter a drug name and …
Other Comments. Small amounts of active drug are found in bile and feces. In exceptional cases patients with infections due to moderately resistant organisms may require increased dosage up to 100 mg/kg/day to achieve blood levels inhibiting the pathogen, but these high doses should be decreased as soon as possible. 125mg ; 250mg; 500mg; 1g; 2g; 10g; General Dosing Guidelines. 1, NCCLS, Wayne, PA, January, 1997.National Committee for Clinical Laboratory Standards. It must not be used in the treatment of trivial infections or where it is not indicated, as in colds, influenza, infections of the throat; or as a prophylactic agent to prevent bacterial infections.Precautions: It is essential that adequate blood studies be made during treatment with the drug. Peaks 10-20 mg/L, troughs 5-10 mg/L. Children with impaired liver or kidney function may retain excessive amounts of the drug.A total of 25 mg/kg/day in 4 equal doses at 6-hour intervals usually produces and maintains concentrations in blood and tissues adequate to control most infections for which the drug is indicated. Optic and peripheral neuritis have been reported, usually following long-term therapy. (See Precaution should be used in therapy of premature and full-term neonates and infants to avoid “gray syndrome” toxicity. After the first two weeks of life, full-term neonates ordinarily may receive up to a total of 50 mg/kg/day equally divided into 4 doses at 6-hour intervals. chloramphenicol-iv-chloromycetin-342554 To facilitate appropriate studies and observation during therapy, it is desirable that patients be hospitalized.IMPORTANT CONSIDERATIONS IN PRESCRIBING INJECTABLE CHLORAMPHENICOL SODIUM SUCCINATE. Tables & Protocols Approved Standard NCCLS Document M2-A6, Vol. Administration of 50 mg/kg/day in divided doses will produce blood levels of the magnitude to which the majority of susceptible microorganisms will respond.The following method of administration is recommended:Intravenously as a 10% (100 mg/mL) solution to be injected over at least a one-minute interval. As soon as feasible an oral dosage form of another appropriate antibiotic should be substituted for intravenous chloramphenicol sodium succinate. Usual Pediatric Dose for Skin or Soft Tissue Infection. 2002 IT HAS BEEN DEMONSTRATED TO BE INEFFECTIVE WHEN GIVEN INTRAMUSCULARLY.In accord with the concepts in the Warning Box and this INDICATIONS AND USAGE section, chloramphenicolmust be used only in those serious infections for which less potentially dangerous drugs are ineffective or contraindicated. )These dosage recommendations are extremely important because blood concentration in all premature and full-term neonates under two weeks of age differs from that of other infants neonates.We comply with the HONcode standard for trustworthy health information - Increased dosage in these individuals, demanded by severe infections, should be given only to maintain the blood concentration within a therapeutically effective range. Adult Pediatric. When these functions are immature (or seriously impaired in adults), high concentrations of the drug are found which tend to increase with succeeding doses.In young infants and other pediatric patients in whom immature metabolic functions are suspected, a dose of 25 mg/kg/day will usually produce therapeutic concentrations of the drug in the blood. In instances of impaired metabolic processes, dosages should be adjusted accordingly. Adults with impairment of hepatic or renal function or both may have reduced ability to metabolize and excrete the drug. A report of “Intermediate” indicates that the result should be considered equivocal, and, if the microorganism is not fully susceptible to alternative, clinically feasible drugs, the test should be repeated. Chloramphenicol is excreted in human milk following oral administration of the drug. Chloramphenicol administered orally is absorbed rapidly from the intestinal tract. She has contributed to a report on children's mental health and has written for an autism website. An irreversible type of marrow depression leading to aplastic anemia with a high rate of mortality is characterized by the appearance weeks or months after therapy of bone marrow aplastic or hypoplasia.
17, No. The body metabolizes and eliminates medications by different pathways.
In this group particularly, the concentration of the drug in the blood should be carefully followed by microtechniques.
Herxheimer’s reactions have occurred during therapy for typhoid fever.Toxic reactions including fatalities have occurred in the premature and neonate; the signs and symptoms associated with these reactions have been referred to as the “gray syndrome.” One case of gray syndrome has been reported in a neonate born to a mother having received chloramphenicol during labor.
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