Is it time to stop using chloramphenicol on the eye?

Mulla, Rohinton; Barnes, Emily; Rogers, Thomas R.

doi:10.1136/bmj.311.7002.450

Cited by 17 publications

(7 citation statements)

References 4 publications

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“…The isolates of EGNB were most sensitive to Chloramphenicol and Amikacin followed by Gentamicin. Though Chloramphenicol was found most sensitive antibiotics, its long term use is quite speculative due to the associated toxic effect (Mulla and Barnes 1997). Almost a quarter of EGNB resisted Amikacin and less than half resisted Gentamicin.…”

Section: Discussionmentioning

confidence: 99%

Bacteriological Profile of Tracheal Aspirates of the Patients Attending Neuro-hospital Nepal

Koirala¹,

Bhatta²,

Ghimire³

et al. 2010

Int J Life Sci

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The tracheostomized patients are colonized mostly by gram negative bacteria which lead to either tracheobronchitis or bronchopneumonia. This study was conducted to isolate and identify the potential pathogen causing post tracheostomy infection. A cross-sectional study was conducted during April 2008 to February 2009 based at Neuro Center, Kathmandu. Tracheal aspirates of 50 patients having fever more than 38°C were collected and analyzed for bacterial content. Out of the 50 cases, 45(90%) cases showed bacterial growth. Sixty-seven isolates were identified; with 20(44.4%) poly-microbial cases. Pseudomonas aeruginosa and enteric gram negative bacteria were predominant bacteria (n=27, 40.3%) followed by Staphylococcus aureus (n=7, 10.4%), other Gram negative bacteria (n=4, 5.9%) and Viridans Streptococci (n=2, 2.9%). Pseudomonas aeruginosa were most sensitive to the Amikacin (n=22, 81.4%) and Ciprofloxacin (n=19, 70.3%). All Pseudomonal isolates were resistant to the Cefotaxime. Enteric Gram Negative bacteria (EGNB) were most sensitive to Amikacin and Chloramphenicol (20, 74.0%) and all were resistant to Ampicillin and Cephalexin. All the gram positive bacteria isolated were sensitive to Vancomycin. Among the total isolates, 24 (88.8%) of Pseudomonas aeruginosa, 21 (66.6%) of enteric gram negative bacteria, and 5 (55.5%) of Gram positive bacteria were multidrug resistant (MDR). The study reported alarming condition of MDR in tracheal aspirates. So surveillance for source of multidrug resistant bacteria would be beneficial for intervention of infection related to it. Key words: Tracheal aspirates, polymicrobial growth, Multidrug resistant bacteria (MDR)10.3126/ijls.v4i0.3496International Journal of Life Sciences Vol.4 2010 pp.60-65

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Section: Discussionmentioning

confidence: 99%

Bacteriological Profile of Tracheal Aspirates of the Patients Attending Neuro-hospital Nepal

Koirala¹,

Bhatta²,

Ghimire³

et al. 2010

Int J Life Sci

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“…It has been postulated that the risk of aplastic anaemia associated with ocular chloramphenicol may be similar to that after oral administration, and a recommendation has been made to restrict its use [1]. This view has been criticised, but no specific epidemiological data have been published [2–6].…”

Section: Introductionmentioning

confidence: 99%

Possible association between ocular chloramphenicol and aplastic anaemia—the absolute risk is very low

Laporte

Vidal

Ballarín

et al. 1998

Brit J Clinical Pharma

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Aims To determine whether topical ocular chloramphenicol increases the risk of aplastic anaemia and to estimate the magnitude of this risk, if any. Methods Population-based prospective case-control surveillance of aplastic anaemia in a community of 4.2 million inhabitants from 1980 to 1995 (67.2 million personyears) plus case-population estimate of the risk, based on sales figures of ocular chloramphenicol in the study area during the study period. Results One hundred and forty-five patients with aplastic anaemia and 1,226 controls were included in the analysis. Three cases (2.1%) and 5 controls (0.4%) had been exposed to ocular chloramphenicol during the relevant etiological period. The adjusted odds ratio was 3.77 (95% confidence interval, 0.84-16.90). Two cases had also been exposed to other known causes of aplastic anaemia. The incidence of aplastic anaemia among users of ocular chloramphenicol was 0.36 cases per million weeks of treatment. The incidence among non users was 0.04 cases per million weeks. Conclusions An association between ocular chloramphenicol and aplastic anaemia cannot be excluded. However, the risk is less than one per million treatment courses.

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“…In more recent years there have been several papers to suggest that some of those cases were unsubstantiated 1,2 and that the incidence is very much lower than previously thought (1 per 20 million). 3 The minimum exposure in any of the cases reported was 18 days, which is more than the average course for acute conjunctivitis.…”

Section: Feedbackmentioning

confidence: 91%