Aristophen (Chloramphenicol)

Description

Chloramphenicol is a low molecular weight, predominantly lipophilic antibiotic and is effective against Gram-positive and Gram-negative bacteria, and also against spirochaete, salmonella, rickettsiae and chlamydiae (trachoma). The mechanism of action has been shown to be by selective inhibition of bacterial protein synthesis. Chloramphenicol is moderately effective against Proteus, Serratia, Klebsiella, Enterobacter, E. coli, Staph. aureus, Enterococci, Streptococci, Salmonellae, Haemophilus influenzae and diplococci. Chloramphenicol is ineffective against Pseudomonas, Mycobacterium, fungi and Protozoa. Known resistance to this antibiotic has not changed significantly in recent years. Chloramphenicol penetrates the cornea thoroughly and therapeutically effective concentration are detectable in the aqueous humour only 15 to 30 minutes after local administration. The half-life is 3-5 hours. In the inflammed eye, the retention time is expected to be shorter. At present there are no data available on the extent of systemic absorption of Chloramphenicol following topical administration to the eye. Up to 50% of the sero-concentration have been detected in breast milk.

Presentation

Aristophen Sterile Eye Drops: Each ml contains Chloramphenicol BP 5 mg.

Indications

Bacterial infections of the anterior segment of the eye (cornea, conjunctiva, uvea anterior), lids and tear ducts. Infection prophylaxis pre and post operatively, after chemical or other burns. Trachoma, herpes zoster ophthalmicus. For prophylactic and therapeutic irrigation of the tear ducts. Chloramphenicol is indicated if the infective agent is resistant to other antibiotics.

Dosage & Administration

Eye drops: Insert one drop into the conjunctival sac 2-4 times per day. In acute cases up to 1 drop every hour. In order to keep the systemic resorption as low as possible, the tear flow should be blocked by pressing with the finger on the side of the nose, near to the corner of the eye, for 1-2 minutes after instillation.

Contrainidications

Hypersensitivity to the ingredients of this drug.
Acute intermittent porphyria.
Severe blood disorders and hepatic dysfunctions due to bone marrow depression.
New-born babies.
Family history of bone marrow depression.

Warning & Precautions

Side effects

Shortly after application a slight burning sensation and a bitter taste in the mouth may occur. Allergic reactions in the form of palpebral eczema have been reported in rare cases. Partially irreversible hematodyscrasia (aplastic anemia, pancytopenia, leukopenia, thrombocytopenia, agranulocytosis) has been observed in isolated cases following topical use of Chloramphenicol. However, the severity and the moment of manifestation of such partially irreversible and lethal effects did not correlate with the commonly elevated dosage used in these studies.
Neuritis nervi after topical use of Chloramphenicol has been reported in isolated cases which recovered after discontinuation of the treatment.

Drug interaction

Chloramphenicol should not be administered simultaneously with bactericidal substances (penicillins, cephalosporins, gentamicin, tetracyclines, polymyxin B, since bacteriostatic antibiotics may inhibit bactericidal antibiotics. Furthermore Chloramphenicol should not be administered at the same time as systemic treatment with drugs which have an adverse effect on hematopoiesis, nor simultaneously with sulphonylureas, coumarin derivatives, hydantoins and methotrexate (precautionary measured).

Use in special groups

Animal experiments with Chloramphenicol have shown adverse effects on the foetus. However, no controlled human studies are available. Aristophen should not be given to pregnant patients or to newborn babies, nor to nursing mothers.