Feder H M
South Med J. 1986 Sep;79(9):1129-34.
Chloramphenicol is a unique antibiotic. The kinetics and efficacy of the oral and intravenous preparations are comparable. Chloramphenicol is usually bacteriostatic but is bactericidal against Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis, and chloramphenicol's clinical efficacy against these meningeal pathogens is well established. Chloramphenicol can be used to treat serious pediatric infections when Haemophilus influenzae is a likely pathogen, as well as typhoid fever, anaerobic infections, bacterial meningitis in patients allergic to penicillin, brain abscesses, and rickettsial infections. The use of chloramphenicol is limited because of its toxicity. Aplastic anemia is very rare but can occur after either oral or intravenous administration. The gray syndrome can be eliminated and marrow suppression minimized by using chloramphenicol at the recommended doses and monitoring levels. During the last decade the increased use of chloramphenicol has not resulted in increased resistance or in frequent reports of toxicity. Thus, chloramphenicol remains an important inpatient antibiotic that can be invaluable for treating certain life-threatening infections.
氯霉素是一种独特的抗生素。口服制剂和静脉制剂的动力学及疗效相当。氯霉素通常具有抑菌作用，但对流感嗜血杆菌、肺炎链球菌和脑膜炎奈瑟菌具有杀菌作用，且氯霉素对这些脑膜病原体的临床疗效已得到充分证实。当流感嗜血杆菌可能是病原体时，氯霉素可用于治疗严重的儿科感染，以及伤寒、厌氧菌感染、对青霉素过敏患者的细菌性脑膜炎、脑脓肿和立克次体感染。由于其毒性，氯霉素的使用受到限制。再生障碍性贫血非常罕见，但口服或静脉给药后均可能发生。通过按推荐剂量使用氯霉素并监测血药浓度，可以避免灰婴综合征并将骨髓抑制降至最低。在过去十年中，氯霉素使用量的增加并未导致耐药性增加或毒性报告频繁出现。因此，氯霉素仍然是一种重要的住院用抗生素，对于治疗某些危及生命的感染可能具有极高的价值。
