Lack of evidence for systemic toxicity following topical chloramphenicol use
There has been considerable controversy regarding the safety of topical chloramphenicol in ophthalmic practice. The evidence for associated haematopoietic toxicity in idiosyncratic and dose-dependent forms was reviewed. The 7 cases of idiosyncratic haematopoietic reactions associated with topical ch...
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| Veröffentlicht in: | Eye (London) 1998-09, Vol.12 (5), p.875-879 |
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| creator | Walker, S Diaper, C J M Bowman, R Sweeney, G Seal, D V Kirkness, C M |
| description | There has been considerable controversy regarding the safety of topical chloramphenicol in ophthalmic practice. The evidence for associated haematopoietic toxicity in idiosyncratic and dose-dependent forms was reviewed. The 7 cases of idiosyncratic haematopoietic reactions associated with topical chloramphenicol reported in the literature are refutable evidence for the existence of such a response. In Scotland, despite extensive prescription of topical chloramphenicol, the incidence of acquired aplastic anaemia was found to be low, as were associated reports of blood dyscrasias throughout the UK. The epidemiology of acquired aplastic anaemia failed to make an association with topical chloramphenicol use. High-performance liquid chromatography (minimum detection limit 1 mg/1) was used to investigate whether serum accumulation of chloramphenicol occurred after topical therapy in 40 patients. The mean dose of chloramphenicol eye drops used after 1 week of treatment was 8.0 mg, and after 2 weeks, 15.3 mg. As expected, chloramphenicol failed to accumulate to detectable levels. This supported the view that topical chloramphenicol was not a risk factor for inducing dose-related bone marrow toxicity. Calls for the abolition of treatment with topical chloramphenicol based on current data are not supported. |
| doi_str_mv | 10.1038/eye.1998.221 |
| format | Article |
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The evidence for associated haematopoietic toxicity in idiosyncratic and dose-dependent forms was reviewed. The 7 cases of idiosyncratic haematopoietic reactions associated with topical chloramphenicol reported in the literature are refutable evidence for the existence of such a response. In Scotland, despite extensive prescription of topical chloramphenicol, the incidence of acquired aplastic anaemia was found to be low, as were associated reports of blood dyscrasias throughout the UK. The epidemiology of acquired aplastic anaemia failed to make an association with topical chloramphenicol use. High-performance liquid chromatography (minimum detection limit 1 mg/1) was used to investigate whether serum accumulation of chloramphenicol occurred after topical therapy in 40 patients. The mean dose of chloramphenicol eye drops used after 1 week of treatment was 8.0 mg, and after 2 weeks, 15.3 mg. As expected, chloramphenicol failed to accumulate to detectable levels. This supported the view that topical chloramphenicol was not a risk factor for inducing dose-related bone marrow toxicity. Calls for the abolition of treatment with topical chloramphenicol based on current data are not supported.</description><identifier>ISSN: 0950-222X</identifier><identifier>EISSN: 1476-5454</identifier><identifier>DOI: 10.1038/eye.1998.221</identifier><identifier>PMID: 10070527</identifier><identifier>CODEN: EYEEEC</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents - adverse effects ; Anti-Bacterial Agents - blood ; Biological and medical sciences ; Child ; Child, Preschool ; Chloramphenicol - adverse effects ; Chloramphenicol - blood ; clinical-study ; Drug Administration Schedule ; Drug toxicity and drugs side effects treatment ; Female ; Hematologic Diseases - chemically induced ; Humans ; Infant ; Laboratory Medicine ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Ophthalmic Solutions ; Ophthalmology ; Pharmaceutical Sciences/Technology ; Pharmacology. 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The evidence for associated haematopoietic toxicity in idiosyncratic and dose-dependent forms was reviewed. The 7 cases of idiosyncratic haematopoietic reactions associated with topical chloramphenicol reported in the literature are refutable evidence for the existence of such a response. In Scotland, despite extensive prescription of topical chloramphenicol, the incidence of acquired aplastic anaemia was found to be low, as were associated reports of blood dyscrasias throughout the UK. The epidemiology of acquired aplastic anaemia failed to make an association with topical chloramphenicol use. High-performance liquid chromatography (minimum detection limit 1 mg/1) was used to investigate whether serum accumulation of chloramphenicol occurred after topical therapy in 40 patients. The mean dose of chloramphenicol eye drops used after 1 week of treatment was 8.0 mg, and after 2 weeks, 15.3 mg. As expected, chloramphenicol failed to accumulate to detectable levels. This supported the view that topical chloramphenicol was not a risk factor for inducing dose-related bone marrow toxicity. Calls for the abolition of treatment with topical chloramphenicol based on current data are not supported.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - adverse effects</subject><subject>Anti-Bacterial Agents - blood</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Chloramphenicol - adverse effects</subject><subject>Chloramphenicol - blood</subject><subject>clinical-study</subject><subject>Drug Administration Schedule</subject><subject>Drug toxicity and drugs side effects treatment</subject><subject>Female</subject><subject>Hematologic Diseases - chemically induced</subject><subject>Humans</subject><subject>Infant</subject><subject>Laboratory Medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Ophthalmic Solutions</subject><subject>Ophthalmology</subject><subject>Pharmaceutical Sciences/Technology</subject><subject>Pharmacology. Drug treatments</subject><subject>Protein Synthesis Inhibitors - adverse effects</subject><subject>Protein Synthesis Inhibitors - blood</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Toxicity: blood</subject><issn>0950-222X</issn><issn>1476-5454</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10D1PwzAQBmALgWgpbMwoAyMpd45TxyNCfEmVWEBiixzHaV3yJTsB8u9xlKpiYbJ09-h89xJyibBEiJJbPeglCpEsKcUjMkfGV2HMYnZM5iBiCCmlHzNy5twOwDc5nJIZAnCIKZ-T9Vqqz6ApAv1lcl0rHRSNDdzgOl0ZFXTNj1GmG3y1LJtvU298qTVKloHalo2VVbvVtVFNGfROn5OTQpZOX-zfBXl_fHi7fw7Xr08v93frUDHkXUg5lyhXWkVAsyxBLlQkESkTHHJgGcsSgTlNUGGsQCLDZBWDENqvLyMaRQtyM81VtnHO6iJtramkHVKEdAwl9aGkYyipD8Xzq4m3fVbp_A-eUvDgeg-k86cVVtbKuIOjfgEQzLNwYs536o226a7pbe0v_e_fYPK17HqrD_M8Gs1IfgHPQYNl</recordid><startdate>19980901</startdate><enddate>19980901</enddate><creator>Walker, S</creator><creator>Diaper, C J M</creator><creator>Bowman, R</creator><creator>Sweeney, G</creator><creator>Seal, D V</creator><creator>Kirkness, C M</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>19980901</creationdate><title>Lack of evidence for systemic toxicity following topical chloramphenicol use</title><author>Walker, S ; Diaper, C J M ; Bowman, R ; Sweeney, G ; Seal, D V ; Kirkness, C M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-277a1a6ec302bb8179c3a1124970d04b4b891d281c15c0a141865099e147a3233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Bacterial Agents - adverse effects</topic><topic>Anti-Bacterial Agents - blood</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Chloramphenicol - adverse effects</topic><topic>Chloramphenicol - blood</topic><topic>clinical-study</topic><topic>Drug Administration Schedule</topic><topic>Drug toxicity and drugs side effects treatment</topic><topic>Female</topic><topic>Hematologic Diseases - chemically induced</topic><topic>Humans</topic><topic>Infant</topic><topic>Laboratory Medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Ophthalmic Solutions</topic><topic>Ophthalmology</topic><topic>Pharmaceutical Sciences/Technology</topic><topic>Pharmacology. Drug treatments</topic><topic>Protein Synthesis Inhibitors - adverse effects</topic><topic>Protein Synthesis Inhibitors - blood</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Toxicity: blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Walker, S</creatorcontrib><creatorcontrib>Diaper, C J M</creatorcontrib><creatorcontrib>Bowman, R</creatorcontrib><creatorcontrib>Sweeney, G</creatorcontrib><creatorcontrib>Seal, D V</creatorcontrib><creatorcontrib>Kirkness, C M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Eye (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Walker, S</au><au>Diaper, C J M</au><au>Bowman, R</au><au>Sweeney, G</au><au>Seal, D V</au><au>Kirkness, C M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lack of evidence for systemic toxicity following topical chloramphenicol use</atitle><jtitle>Eye (London)</jtitle><stitle>Eye</stitle><addtitle>Eye (Lond)</addtitle><date>1998-09-01</date><risdate>1998</risdate><volume>12</volume><issue>5</issue><spage>875</spage><epage>879</epage><pages>875-879</pages><issn>0950-222X</issn><eissn>1476-5454</eissn><coden>EYEEEC</coden><abstract>There has been considerable controversy regarding the safety of topical chloramphenicol in ophthalmic practice. The evidence for associated haematopoietic toxicity in idiosyncratic and dose-dependent forms was reviewed. The 7 cases of idiosyncratic haematopoietic reactions associated with topical chloramphenicol reported in the literature are refutable evidence for the existence of such a response. In Scotland, despite extensive prescription of topical chloramphenicol, the incidence of acquired aplastic anaemia was found to be low, as were associated reports of blood dyscrasias throughout the UK. The epidemiology of acquired aplastic anaemia failed to make an association with topical chloramphenicol use. High-performance liquid chromatography (minimum detection limit 1 mg/1) was used to investigate whether serum accumulation of chloramphenicol occurred after topical therapy in 40 patients. The mean dose of chloramphenicol eye drops used after 1 week of treatment was 8.0 mg, and after 2 weeks, 15.3 mg. As expected, chloramphenicol failed to accumulate to detectable levels. This supported the view that topical chloramphenicol was not a risk factor for inducing dose-related bone marrow toxicity. Calls for the abolition of treatment with topical chloramphenicol based on current data are not supported.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>10070527</pmid><doi>10.1038/eye.1998.221</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Anti-Bacterial Agents - adverse effects Anti-Bacterial Agents - blood Biological and medical sciences Child Child, Preschool Chloramphenicol - adverse effects Chloramphenicol - blood clinical-study Drug Administration Schedule Drug toxicity and drugs side effects treatment Female Hematologic Diseases - chemically induced Humans Infant Laboratory Medicine Male Medical sciences Medicine Medicine & Public Health Middle Aged Ophthalmic Solutions Ophthalmology Pharmaceutical Sciences/Technology Pharmacology. Drug treatments Protein Synthesis Inhibitors - adverse effects Protein Synthesis Inhibitors - blood Surgery Surgical Oncology Toxicity: blood |
| title | Lack of evidence for systemic toxicity following topical chloramphenicol use |
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