Aplastic anemia following chloramphenicol therapy still happens

To the Editor.— Chloramphenicol is still the drug of choice for treatment of ampicillin-resistant Haemophilus influenzae b meningitis, brain abscess,1 Rocky Mountain spotted fever in severely ill patients and young children, and typhoid fever. Intravenous oral and intraocular routes of administration have been widely used. Smith and Webber2 have recently reviewed the pharmacology of chloramphenicol. Reversible erythroid suppression is dose related and more common in children. Genetic predisposition of the stem cell to inhibition of nucleic acid synthesis is thought to be the explanation for the "idiosyncratic" chloramphenicol-induced bone marrow aplasia, although Daum et al3 reported a probable dose-related case.