Chloramphenicol allergy

Chloramphenicol allergy is not uncommon (Robinson 1957), occuring in 15 of 550 patients treated topically. Cross-sensitization to 2,4-dinitrochlorobenzene has been debated but recently found not to occur (Eriksen 1978). Azidamphenicol, used as the antibiotic in a steroid-antibiotic combination cream, caused worsening of eczema under treatment in several cases, but contact allergy was only confirmed in four cases. Cross-reaction to chloramphenicol was found in all but one (Wereide 1975). 

In a review article on the haematotoxic effects of thiamphenicol and chloramphenicol it is stated that dose-related blood dyscrasias during treatment with these antibiotics chiefly include erythroid suppression, and that thiamphenicol is more inhibitory to erythropoiesis than chloramphenicol. Allergy to both drugs reportedly may, following re-exposure, lead to a dangerous agranulocytosis. The author concludes that a dosis of thiamphenicol which is anti-biotically active and certainly not myelotoxic is unknown as yet (34 ). 

PCN-sensitive staph) Action Bact icidal -1- cell wall synth Spectrum Most gram(+), including str Dose Adults. 250-500 mg PO q6h, q8h, q 12h Peds. 25-50 mg/kg/25h PO in 4 doses -1- in renal impair on empty stomach Caution [B, M] Contra Allergy Disp Tabs, susp SE GI upset, int stitial nephritis, anaphylaxis, convulsions Interactions -1- Effects W/ ASA, probenecid t effects OF MTX t risk of anaphylaxes W/BB -1- effects W/ chloramphenicol, macrolides, tetracyclines X effects OF OCPs EMS Monitor for sup Infxn T effects of anticoagulants monitor for signs of electrol5rte disturbances and h5 povolemia d/t D OD May cause N/D and Szs activated charcoal may be effective... 

Uses Infxns of resp tract, skin/soft tissue, scarlet fever, syphilis Action Bactericidal X cell wall synth Dose Adults. 0.6—4.8 million Units/d in - doses ql2-24h give probenecid at least 30 min prior to PCN to prolong action Peds. 25,000-50,000 Units/kg/d EM - daily-bid Caution [B, M] Contra Allergy Disp Inj SE Pain at inj site, interstitial nephritis, anaphylaxis Interactions T Effects W/ probenecid T penicillin 1/2-life W/ ASA, furosemide, indomethacin, sulfonamides, thiazide diuretics T risk of bleeding W/ anticoagulants X effects W/ chloramphenicol, macrolides, tetracyclines X effects OF OCPs EMS See Penicillin G, Aqueous OD See Penicillin G, Aqueous... 

Chloramphenicol is an alternative drug for meningitis caused by H. influenzae, N. meningitidis, and S. pneumoniae in patients who have severe allergy to fTlactams and in developing countries. 

Sulfonamides have minimal therapeutic actions in rickettsial infections. Chloramphenicol may be used for Rocky Mountain spotted fever in patients with established allergy or other contraindication to tetracyclines. The answer is (C). 

Eriksen K (1978) Cross allergy between paranitro compounds with special reference to DNCB and chloramphenicol. Contact Dermatitis 4 29-32 Fanta D, Mischer P (1976) Contact dermatitis from tromantadine hydrochloride. Contact Dermatitis 2 282-284... 

Keiser G, Bolli P, Buchegger U (1972) Hamatologische Nebenwirkungen von Chloramphenicol und Thiamphenicol. Schweiz Med Wochenschr 102 1595-1598 Ketel WG van (1976) Immediate- and delayed-type allergy to erythromycin. Contact Dermatitis 2 363-364... 

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