I recall working for a chest physician (1992) who loved to use
Chloramphenicol 250mg qds on all his COPD patients when admitted as
in-patients. He argued:
1: The drug has excellent broad spectrum activity, especially against H.
Influenzae
2: The drug achieves excellent sputum penetrance
3: Resistance is rare (but not so nowadays - some R even in Salmonella
typhi)
4: Its not too expensive (approx. £6 for 5 days)
I watched it work wonderfully well - but I don't use it at present - Why?
Should I be that concerned over a 1 in 40,000 incidence of fatal aplastic
anaemia when, in the case of severe COPD I could 'kill' a patient through
inadequately treating his chest infection with an ineffective antibiotic?
Is the bad publicity against Chloramphenicol an example of doctors being
overalarmed by reports in the media?
Our local Consultant Microbiologist was against my suggestion that severe
COPD was an indication for systemic Chloramphenicol - comments please
Johnathan Cobb
Sheffield, UK
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