Minims (Chloramphenicol)

Chloramphenicol ophthalmic solution is a broad‑spectrum antibacterial agent used to treat infections of the ocular surface and related structures.

• Bacterial conjunctivitis: decreases bacterial colonisation on the conjunctiva, reducing redness, purulent discharge, itching, swelling and discomfort, thereby accelerating symptom relief.
• Blepharitis: eradicates pathogenic bacteria from eyelid margins, diminishing crust formation, lid edema, irritation and redness, and supporting normal eyelid function.
• Keratitis: suppresses corneal bacterial growth, limiting ulceration, pain, visual impairment and scarring, and facilitating corneal epithelial regeneration.
• Ocular surface infection: provides broad‑spectrum coverage against mixed bacterial pathogens affecting the cornea and conjunctiva, aiding infection control.

• Chloramphenicol exerts its antibacterial effect by binding to the 50S subunit of bacterial ribosomes. This interaction blocks the peptidyl transferase activity, preventing formation of peptide bonds during protein synthesis. The resulting inhibition of bacterial protein production halts bacterial growth, rendering the drug bacteriostatic against a wide range of Gram‑positive and Gram‑negative ocular pathogens. It is effective against common ocular isolates such as Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae, though resistance may occur.

Chloramphenicol ophthalmic solution may cause local and systemic adverse reactions, although most patients tolerate it well.

Common Side Effects

• Eye irritation: transient burning or stinging sensation upon instillation.
• Redness: mild conjunctival hyperemia.
• Tearing: increased lacrimation.
• Blurred vision: temporary visual disturbance that resolves.

Serious or Rare Side Effects

• Allergic reaction: swelling, itching, or rash around the eye indicating hypersensitivity.
• Bone marrow suppression: rare systemic effect leading to anemia or leukopenia.
• Stevens‑Johnson syndrome: extremely rare severe skin and mucous membrane reaction.

When using chloramphenicol eye drops, several precautions should be observed to minimize risks and ensure optimal therapy.

• Pregnancy: Category D; avoid use unless benefits outweigh potential fetal risks.
• Breastfeeding: Not recommended as drug may be excreted in milk.
• Hypersensitivity: Discontinue if signs of allergic reaction appear.
• Contact lens wear: Remove lenses before application and wait before reinserting.
• Concomitant ocular infection: Evaluate for alternative therapy if fungal infection is suspected.
• Store at room temperature: keep in original container, protect from light and moisture.

Chloramphenicol eye drops can interact with certain systemic and topical agents, affecting efficacy or safety.

Major Interactions (Avoid)

• Systemic aminoglycosides: combined use may increase risk of ototoxicity and nephrotoxicity.
• Systemic anticoagulants: may enhance anticoagulant effect, raising bleeding risk.

Moderate Interactions (Monitor Closely)

• Other ophthalmic antibiotics: concurrent use may lead to antagonism or additive toxicity.
• Non‑steroidal anti‑inflammatory eye drops: may increase local irritation.
• Systemic CYP inducers: may reduce chloramphenicol levels, diminishing efficacy.