Chloramphenicol: what it treats and how to use it safely

Chloramphenicol is a broad‑spectrum antibiotic that still shows up in eye drops and, less often, in systemic form for serious infections. It works by stopping bacteria from making proteins they need to grow. That makes it useful for bacterial conjunctivitis and some hard‑to‑treat infections when other drugs aren’t an option.

Before using chloramphenicol, know the two main facts: topical (eye) use is common and usually safe; systemic use can be effective but carries a rare, serious risk called aplastic anemia. That risk is why doctors reserve oral or IV chloramphenicol for specific situations.

Common uses and forms

Topical chloramphenicol comes as eye drops or ointment and treats bacterial eye infections like conjunctivitis. People like it because it’s broad against many bacteria and often affordable. Systemic chloramphenicol (tablet or IV) may be used for life‑threatening infections in places where safer alternatives aren’t available or when a bacterium resists other antibiotics.

If you’re treating an eye infection, follow the prescribed schedule exactly. Use drops for the full course even if symptoms clear quickly. Stopping early can let the infection return or leave resistant bacteria behind.

Side effects, warnings, and monitoring

Most people using chloramphenicol eye drops get mild local irritation at most. For oral or IV use, watch for gastrointestinal upset and more serious bone marrow effects. The big warning is aplastic anemia — very rare but potentially fatal. Because of that, doctors usually check blood counts (CBC) during systemic treatment and advise reporting new bruising, unusual bleeding, severe fatigue, or fever right away.

Pregnancy and breastfeeding need extra care. Topical eye use is often allowed with caution, but systemic use should only happen when benefits clearly outweigh risks. Tell your clinician if you’re pregnant, breastfeeding, or planning pregnancy.

Drug interactions are fewer with topical use but matter for systemic therapy. Chloramphenicol can affect how the liver breaks down some drugs and may increase levels of medicines like certain anticoagulants. Always tell your provider about all the medicines and supplements you take.

Resistance and alternatives: bacterial resistance has reduced chloramphenicol’s role in many places. For eye infections, alternatives include topical azithromycin, tobramycin, or fusidic acid depending on local guidelines and allergy history. For systemic infections, safer modern agents are usually preferred when available.

Storage and disposal: keep eye drops in a cool, dry place and throw them out after the vendor‑recommended period once opened (often 28 days). Don’t share eye drops or use medication prescribed for someone else.

If you have questions about a prescription or notice worrying symptoms, contact your healthcare provider. Chloramphenicol can be a useful tool, but it works best when used carefully and under proper medical guidance.