Anemia during Haemophilus influenzae type b meningitis: lack of an effect of chloramphenicol.

We sought to determine whether chloramphenicol would worsen or mitigate the anemia associated with Haemophilus influenzae type b meningitis if administered in doses which produce 'therapeutic' serum concentrations. Seventy-four cases of H. influenzae meningitis were stratified by chloramphenicol cumulative doses (mg/kg body weight) of less than 300 and greater than 300. There was no significant difference in the decrease in blood hemoglobin concentration or in the increase in the FEP:Heme ratio between the two study groups. Plasma iron and transferrin saturation values indicated iron deficiency at days 1 and 5 of hospitalization; by day 10 mean values were within the normal range. These data suggest that H. influenzae type b meningitis, not chloramphenicol therapy in the presence of monitoring is causing the observed anemia.