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  • Chloramphenicol is a powerful antibacterial with a broad range that includes gram positive bacteria, gram negative bacteria, anaerobic bacteria. It is commonly used in developing countries; however, due to its potentially serious side effects its use in the US is limited to situations where no alternative treatment exists.
Mechanism of Action
  • Chloramphenicol inhibits the 50S subunit of the bacterial ribosome.
Adverse Effects
  • Anemia:
    • Chloramphenicol predictably causes a dose-related, reversible anemia at high concentrations.
  • Aplastic Anemia:
    • This irreversible anemia is extremely rare but potentially fatal and occurs idiosyncratically with little correlation to the dosage.
  • Gray Baby Syndrome:
    • Neonates eliminate the drug much more slowly than adults due to reduced efficiency of hepatic xenobiotic metabolism. Therefore, much higher concentrations of chloramphenicol can accumulate in neonates if the dosage is not properly adjusted. This can result in shock and attendant cyanosis which manifests as grey skin, providing the syndrome's namesake.