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Chloramphenicol (Cleocin)
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Chloramphenicol

Chloramphenicol (generic name: clindamycin; brand names include: Clindatec / Dalacin / Clinacin / Evoclin) is used to treat a wide variety of serious bacterial infections including infections of the respiratory tract, skin and soft tissue, pelvis, vagina, and abdomen. It is also used to treat bone and joint infections, particularly those caused by Staphylococcus aureus. Chloramphenicol kills sensitive bacteria by stopping the production of essential proteins needed by the bacteria to survive.

Other names for this medication:
Antirobe, Basocin, Biodaclin, Clendix, Cleocin, Clidan, Climadan, Clinacin, Clinda, Clindacin, Clindacne, Clindagel, Clindahexal, Clindal, Clindamax, Clindamicina, Clindasol, Clindesse, Clindets, Clinium, Clinsol, Clinwas, Cutaclin, Dalacin, Dentomycin, Derma, Dermabel, Evoclin, Klimicin, Klindamicin, Klindan, Mediklin, Sobelin, Tidact, Ziana, Zindaclin

Similar Products:
Clinda derm, Clindagel, Clindets

 

Also known as:  Cleocin.

Description

Chloramphenicol is a prescription medication used to treat bacterial infections of the lungs, skin, blood, bones, joints, female reproductive system, and internal organs.

Chloramphenicol belongs to a group of drugs called lincomycin antibiotics. These work by stopping the growth of bacteria.

This medication is available as a vaginal cream, vaginal suppository, oral capsule, and oral liquid.

This medication is also available in injectable forms to be given directly into a vein (IV) or a muscle (IM) by a healthcare professional.

Common side effects of Chloramphenicol include nausea, vomiting, joint pain, heartburn, pain when swallowing, and white patches in the mouth.

Dosage

Take Chloramphenicol exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Take the capsule with a full glass of water to keep it from irritating your throat.

Measure the oral liquid with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Chloramphenicol is sometimes given as an injection into a muscle, or injected into a vein through an IV. You may be shown how to use injections at home. Do not self-inject this medicine if you do not understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Use a disposable needle only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

To make sure this medicine is not causing harmful effects, you may need frequent medical tests during treatment.

If you need surgery, tell the surgeon ahead of time that you are using Chloramphenicol.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Chloramphenicol will not treat a viral infection such as the flu or a common cold.

Store at room temperature away from moisture and heat. Protect the injectable medicine from high heat.

Do not store the oral liquid in the refrigerator. Throw away any unused oral liquid after 2 weeks.

Overdose

In the event the patient misses a dose of Chloramphenicol, the patient should take it as soon as possible. However, if it is almost time for the next scheduled dose, taking another dose of Chloramphenicol may cause an overdose which can lead to serious health complications. In this case, the missed dose should be skipped entirely to avoid an overdose potential. If an overdose of Chloramphenicol is suspected the patient should seek immediate medical intervention and assessment. An overdose may involve symptoms such as changes in mood or behaviors, thoughts of self harm, suicidal thoughts, seizures, or convulsions.

Storage

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Chloramphenicol are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not use Generic Chloramphenicol if you are allergic to Generic Chloramphenicol components or to to tartrazine.

Be very careful if you're pregnant or you plan to have a baby, or you are a nursing mother.

Try to be very careful with Generic Chloramphenicol if it is given to children younger than 10 years old who have diarrhea or an infection of the stomach or bowel. Elderly patient should use Generic Chloramphenicol with caution.

Be sure to use Generic Chloramphenicol for the full course of treatment.

Avoid alcohol.

It can be dangerous to stop Generic Chloramphenicol taking suddenly.

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In the attempt to enrich the local contemporary laboratory data regarding the group B streptococcus (GBS) colonization, isolates obtained from the vaginal swab cultures were characterized for their serotype distribution and antibiotic susceptibility. The 100 GBS isolates analyzed were collected during a four-month period of year 2009 from women screened in ambulatory for vaginal carriage of GBS. The GBS isolates were classified based on their capsular polysaccharide structures using commercially available antisera. Susceptibility to penicillin, ampicillin, erithromycin, clindamycin, tetracycline, ofloxacin, and chloramphenicol was initially tested using antibiotic disk diffusion technique according to CLSI guidelines. Minimum inhibitory concentrations of erythromycin and tetracycline for the isolates with reduced susceptibility were evaluated according to the CLSI criteria and macrolide-lincosamide-streptogramin B (MLSB) resistance was investigated by a double-disk test with erythromycin and clindamycin disks. All the GBS isolates were serotypeable. Their distribution comprised six different serotypes of which serotypes II (26%), III (26%), and Ia (19%) prevailed and no serotype VI, VII, and VIII isolates were found. Overall, the GBS isolates were fully susceptible to penicillin and ampicillin, but the rates of susceptibility to the other antimicrobial agents tested were decreased, ranging from 87% for chloramphenicol to 5% for tetracycline. Reduced susceptibility to clindamycin and erythromycin was detected in 18% and 19% of isolates, respectively. For the latter, 84% displayed a constitutive MLSB phenotype, 11% had an inducible MLSB phenotype, and M phenotype was expressed by 5% of them. Erythromycin-resistant GBS isolates displayed concurrently resistance to at least one more antibiotic. In conclusion, according to our study the most frequent GBS serotypes isolated from the vaginal microflora were II and III, followed by serotype Ia. While the GBS isolates remain susceptible to beta-lactams, resistance to alternative antimicrobial drugs such as erythromycin and clindamycin seems to be an increasing concern for our region. Further phenotypic and genotypic studies are required to identify specific aspects of GBS strains colonizing or infecting the local population.

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Of the 140 women with laparoscopically confirmed acute salpingitis, 61 (44%) women had mild, 38 (27%) had moderate, and 41 (29%) had severe disease (ie, pyosalpinx, tuboovarian abscesses, or both). Fifty-three (38%) were HIV-1-infected. Severe disease was more common in HIV-1-infected in comparison with HIV-1-uninfected women (20 [38%] compared with 21 [24%], P = .02). Defined as time of hospital discharge or 75% or more reduction in baseline clinical severity score, HIV-1-infected women with severe (6 days [4-16] compared with 5 days [3-9], P = .09) but not those with either mild (4 days [2-6] compared with 4 days [2-6] P = .4) or moderate salpingitis (4 days [3-7] compared with 4 days [3-6] P = .32) tended to take longer to meet criteria for clinical improvement. The need for intravenous clindamycin or additional surgery was not different in HIV-1-infected and uninfected cases (15 [28%] compared with 18 [21%], P = .3).

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Forty-five of the 55 (81.8%) S. aureus isolates from inpatients, and 319 (90.6%) isolates from tested 352 out-patient's isolates were suspected to all the antibiotics tested. methicillin-resistant S. aureus (MRSA) was detected in 1.2% of S. aureus isolates. Rifampin, trimethoprim-sulfamethoxazole, clindamycin, erythromycin, gentamicin resistance rates were 1.2%, 1.7%, 2.0%, 8.8%, and 1.2%, respectively. The isolates were susceptible to teicoplanin and vancomycin. The genes most frequently found were tst (92.7%), seg (85.8%), sea (83.6%), fnbA (70.9%). There was no statistical significance detected between MRSA and mecA-negative S. aureus isolates in encoding genes distribution (P > 0.05).

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A total of 937 children residing in Addis Ababa (n=491), Gondar (n=265) and Dire-Dawa (n=181) were investigated during a period between November 2004 and January 2005. Throat specimens were collected and cultured using standard procedure. Beta haemolytic streptococci were serogrouped by agglutination tests using specific antisera. Antimicrobial susceptibility testing of the isolates was performed by diffusion method.

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Adult diabetic patients admitted to our Diabetes Center from September 1996 to January 1998 for severe, limb-threatening foot infection were consecutively enrolled in a prospective, randomized, controlled clinical study aimed at assessing the safety and efficacy of recombinant human granulocyte colony-stimulating factor (G-CSF) (lenograstim) as an adjunctive therapy for the standard treatment of diabetic foot infection. Forty patients, all of whom displayed evidence of osteomyelitis and long-standing ulcer infection, were randomized 1:1 to receive either conventional treatment (i.e., antimicrobial therapy plus local treatment) or conventional therapy plus 263 microg of G-CSF subcutaneously daily for 21 days. The empiric antibiotic treatment (a combination of ciprofloxacin plus clindamycin) was further adjusted, when necessary, according to the results of cultures and sensitivity testing. Microbiologic assessment of foot ulcers was performed by both deep-tissue biopsy and swab cultures, performed at enrollment and on days 7 and 21 thereafter. Patients were monitored for 6 months; the major endpoints (i.e., cure, improvement, failure, and amputation) were blindly assessed at weeks 3 and 9. At enrollment, both patient groups were comparable in terms of both demographic and clinical data. None of the G-CSF-treated patients experienced either local or systemic adverse effects. At the 3- and 9-week assessments, no significant differences between the two groups could be observed concerning the number of patients either cured or improved, the number of patients displaying therapeutic failure, or the species and number of microorganisms previously yielded from cultures at day 7 and day 21. Conversely, among this small series of patients the cumulative number of amputations observed after 9 weeks of treatment appeared to be lower in the G-CSF arm; in fact, only three patients (15%) in this group had required amputation, whereas nine patients (45%) in the other group had required amputation (P = 0.038). In conclusion, the administration of G-CSF for 3 weeks as an adjunctive therapy for limb-threatening diabetic foot infection was associated with a lower rate of amputation within 9 weeks after the commencement of standard treatment. Further clinical studies aimed at precisely defining the role of this approach to this serious complication of diabetes mellitus appear to be justified.

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Efficacy of the ketoconazole/klindamycin vs metronidazole/nistatine combination to treat Candida vaginitis and bacterial vaginosis by vaginal route was compared. Patients with diagnosis of vaginitis and bacterial vaginosis were included in a longitudinal, prospective, double-blind study. Patients were treated with ketoconazole/clindamycin vaginal tablets or metronidazole/ nistatine ovules for 6 days. Patients were evaluated at baseline and at day 7.

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Streptococcal toxic shock syndrome (STSS) is a severe invasive infection characterized by the sudden onset of shock, multi-organ failure, and high mortality. In Japan, appropriate notification measures based on the Infectious Disease Control law are mandatory for cases of STSS caused by β-haemolytic streptococcus. STSS is mainly caused by group A streptococcus (GAS). Although an average of 60-70 cases of GAS-induced STSS are reported annually, 143 cases were recorded in 2011. To determine the reason behind this marked increase, we characterized the emm genotype of 249 GAS isolates from STSS patients in Japan from 2010 to 2012 and performed antimicrobial susceptibility testing. The predominant genotype was found to be emm1, followed by emm89, emm12, emm28, emm3, and emm90. These six genotypes constituted more than 90% of the STSS isolates. The number of emm1, emm89, emm12, and emm28 isolates increased concomitantly with the increase in the total number of STSS cases. In particular, the number of mefA-positive emm1 isolates has escalated since 2011. Thus, the increase in the incidence of STSS can be attributed to an increase in the number of cases associated with specific genotypes.

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A total of 175 patients were included [median age 81 years (IQR = 12), 46.9% males], 103 in the group with a 24 h DSHT and 72 in the group with a 72/96 h DSHT. The group with a 24 h DSHT had a lower diarrhoea frequency (13.6% vs. 34.7%, risk ratio: 0.39, 95% CI: 0.22-0.70, p = 0.001) and a lower diarrhoea incidence rate (0.87 vs. 2.32 cases of diarrhoea/100 patient*day, rate ratio: 0.37, 95% CI: 0.19-0.72, p = 0.004). The Kaplan-Meier curves showed a longer diarrhoea-free survival for this group (p = 0.003, log-rank test). A 24 h DSHT was associated with a lower risk of diarrhoea (HR = 0.27, 95% CI: 0.12-0.61, p = 0.002), adjusted by albumin, stroke severity, intravenous thrombolysis, the administration of clindamycin and cefotaxime, and the administration of an enteral formula for diabetic patients.

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Staphylococcus aureus infections are a major cause of morbidity and mortality worldwide. Clindamycin is widely used in the treatment of staphylococcal infections; however, it is our impression that in the Optamox Suspension Precio last few years, inducible clindamycin resistance (ICR) has become more prevalent.

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Reports of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections have recently increased in Japan. To determine the status of MRSA infections in our hospital, we investigated their Staphylococcal cassette chromosome mec (SCCmec) types and prevalence of Panton-Valentine leukocidin (PVL). In addition, we investigated the relation between their SCCmec and antimicrobial susceptibility. The 191 strains were isolated from January to July in 2011 and were classified as SCCmec type I (2, 1.0%), type II (136, 71.2%), type IV (36, 18.8%), type V (4, 2.1%) and type VIII (2, 1.0%). Eleven isolates (5.8%) were designated as nontypable. No isolates Topcef Tablet Purpose were PVL-positive in this study. The SCCmec type IV strains were more susceptible to imipenem (MIC90, 0.25 μg/ml) than SCCmec type II strains (MIC90, >16 μg/ml). This difference was also observed between SCCmec type IV and SCCmec type II in susceptibility levels to clarithromycin, clindamycin, minocycline, and levofloxacin, but not to gentamicin. In particular, SCCmec type IV strains were susceptible to imipenem and minocycline. The result indicates these susceptibility is useful to discriminate CA-MRSA from Hospital-associated MRSA (HA-MRSA).