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chloramphenicol
generic
Black Box Warnings .
Appropriate Use
hospitalize pts for observation and hematologic monitoring during admin.
Blood Dyscrasias
serious and fatal blood dyscrasias (incl. aplastic or hypoplastic anemia, thrombocytopenia, and granulocytopenia) may occur w/ short or prolonged tx; some reports of aplastic anemia ended in leukemia; avoid use in trivial infections or where not indicated or when safer alternate tx exists
Adult Dosing .
Dosage forms: INJ
infections, bacterial
- [50-100 mg/kg/day IV divided q6h]
- Max: 100 mg/kg/day; Info: not considered 1st line tx for any infection; adjust dose based on levels
infections, rickettsial
- [50-100 mg/kg/day IV divided q6h]
- Max: 100 mg/kg/day; Info: not considered 1st line tx for any infection; adjust dose based on levels
meningitis, bacterial
- [4 g/day IV divided q6h]
- Alt: 75-100 mg/kg/day IV divided q6h; 6 g/day IV divided q6h if pneumococcal; Info: not considered 1st line tx; adjust dose based on levels
anthrax, systemic (off-label)
- [1 g IV q6-8h for at least 2wk]
- Info: for CNS anthrax; not 1st-line agent; part of multi-drug regimen; switch to PO abx for post-exposure prophylaxis if inhalational exposure
renal dosing
- [see below]
- renal impairment: decr. usual dose, amount not defined
- HD: no adjustment, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: no adjustment; no supplement
hepatic dosing
- [adjust dose amount]
- hepatic impairment: decr. usual dose, amount not defined
Peds Dosing .
- Dosage forms: INJ
infections, bacterial
- [premature neonates <1.2 kg]
- Dose: 22 mg/kg/dose IV qd; Start: 20 mg/kg/dose IV x1; Info: give 1st maint. dose 12h after start dose; adjust dose based on levels; premature neonates >1.2 kg use same dosing as full-term neonates
- [neonates 0-7 days old or <2 kg]
- Dose: 25 mg/kg/dose IV qd; Start: 20 mg/kg/dose IV x1; Info: give 1st maint. dose 12h after start dose; adjust dose based on levels
- [neonates >7 days old and >2 kg]
- Dose: 50 mg/kg/day IV divided q12h; Start: 20 mg/kg/dose IV x1; Info: adjust dose based on levels
- [infants/children]
- Dose: 50-75 mg/kg/day IV divided q6h; Max: 4 g/day; Info: adjust dose based on levels
meningitis
- [infants/children]
- Dose: 75-100 mg/kg/day IV divided q6h; Max: 4 g/day; Info: adjust dose based on levels
anthrax, systemic (off-label)
- [neonates >32 wk gestation]
- Dose: 25-50 mg/kg/dose IV q12-24h for at least 2wk; Info: for CNS anthrax; not 1st-line agent; part of multi-drug regimen; dose, frequency depend on gestational and post-natal age; switch to PO abx x60 days total if inhalational exposure
- [1 mo and older]
- Dose: 100 mg/kg/day IV divided q6h for at least 2wk; Info: for CNS anthrax; not 1st-line agent; part of multi-drug regimen; switch to PO abx x60 days total if inhalational exposure
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: consider adult renal dosing for guidance
hepatic dosing
- [adjust dose amount]
- hepatic impairment: decr. usual dose, amount not defined