ABSTRACT
This chapter reviews the antimicrobial spectrum, pharmacokinetics, toxicity, dosing, recommendations for therapeutic monitoring, and current clinical indications for chloramphenicol. Chloramphenicol is inactivated by enzymes which are found in filtrates of some bacteria and which reduce the nitro group and hydrolyze the amide linkage. Chloramphenicol acts to inhibit protein synthesis in susceptible organisms by reversibly binding to the 50 S ribosomal subunit of bacterial 70 S ribosomes. The in vivo resistance of microorganisms usually susceptible to chloramphenicol, especially H. influenzae and salmonella, is an increasingly difficult problem. Chloramphenicol has been shown to inhibit the early, rapid killing effect of penicillin in vitro for Streptococcus pyogenes and Klebsiella pneumonia. An understanding of available assay methodologies utilized to measure chloramphenicol serum levels is essential to interpret susceptibility data, assess pharmacokinetics, and interpret studies of chloramphenicol usage. Assessment of the absorption and bioavailability of chloramphenicol varies with the preparation administered.
