Kloramfenikol ”santen” (Chloramphenicol)

Chloramphenicol ophthalmic antibiotic is used to treat bacterial infections of the ocular surface and related structures.

• Bacterial conjunctivitis: reduces bacterial load and accelerates resolution of redness, discharge and irritation.
• Keratitis: eradicates causative bacteria, promoting corneal healing and preventing scarring.
• Other ophthalmic bacterial infections: controls infection in conditions such as blepharitis or postoperative ocular wounds.

• Chloramphenicol penetrates the corneal epithelium and binds to the 50S subunit of bacterial ribosomes. This binding blocks peptide bond formation, halting protein synthesis and leading to bacteriostatic inhibition of susceptible Gram‑positive and Gram‑negative organisms. The localized ocular delivery achieves high concentrations at the site of infection while limiting systemic exposure. It remains active in the tear film for several hours, providing sustained antimicrobial activity during the dosing interval.

Topical chloramphenicol may cause local and, rarely, systemic adverse reactions.

Common Side Effects

• Eye irritation: mild burning or stinging upon instillation.
• Redness: transient conjunctival hyperemia.
• Tearing: increased lacrimation.
• Blurred vision: temporary visual disturbance.
• Foreign body sensation: feeling of grit in the eye.
• Pruritus: mild itching of the ocular surface.

Serious or Rare Side Effects

• Allergic reaction: swelling, rash or hives around the eye.
• Stevens‑Johnson syndrome: severe mucocutaneous blistering.
• Aplastic anemia: systemic bone‑marrow suppression (rare with prolonged use).
• Severe ocular inflammation: uveitis or keratitis worsening.
• Vision loss: sudden decrease in visual acuity.
• Systemic toxicity: nausea, vomiting or dizziness if absorbed in large amounts.

When using chloramphenicol eye drops, several precautions should be observed to ensure safety and effectiveness.

• Allergy assessment: avoid use in patients with known hypersensitivity to chloramphenicol or related compounds.
• Pregnancy and lactation: prescribe only if potential benefit justifies potential risk to the fetus or infant.
• Contact lens wearers: discontinue lenses during treatment and resume only after therapy completion.
• Concomitant ocular medications: avoid mixing with other eye drops unless directed by a healthcare professional.
• Prolonged therapy: monitor for signs of bone‑marrow suppression, especially with extended use.
• Store at room temperature: keep in the original container, protect from light and moisture.

Chloramphenicol ophthalmic solution can interact with certain systemic and topical agents; awareness of these interactions helps prevent adverse outcomes.

Major Interactions (Avoid)

• Warfarin: chloramphenicol may potentiate anticoagulant effect, increasing bleeding risk.
• Cytotoxic chemotherapy: additive bone‑marrow suppression may occur.

Moderate Interactions (Monitor Closely)

• Topical non‑steroidal anti‑inflammatory drugs (NSAIDs): may increase ocular irritation.
• Systemic tetracyclines: potential for additive toxicity affecting the eye.
• Other ophthalmic antibiotics: concurrent use may reduce efficacy or increase resistance.