Informational only — Not medical advice. Always consult a licensed healthcare provider.

MedBD
বাং
Community data Updated 2 months ago
🌐 বাংলায় দেখুন

Indications

Ramicol is an antibiotic that has a specific, limited role: it's meant for serious infections caused by organisms that respond to it, and only when safer treatment options either won't work or can't be used. That said, a doctor may still start Ramicol based on a clinical suspicion that one of the conditions below is present, before this is confirmed. Lab sensitivity testing should be done alongside treatment, so the drug can be stopped promptly if a safer alternative turns out to be effective. If both Ramicol and another antibiotic appear effective against a particular organism in lab testing, the choice to continue with Ramicol rather than switch should weigh how severe the infection is, how susceptible the organism is to each drug, and how well each drug actually works against that infection.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

In vitro, chloramphenicol exerts mainly a bacteriostatic effect on a wide range of Gram-negative and Gram positive bacteria and is active against rickettsiae, the lymphogranuloma-psittacosis group and Vibrio cholerae. It is particularly active against Salmonella typhi and Haemophilus influenzae. The mode of actions is through interference or inhibition of protein synthesis in intact cells and cell-free systems. Antagonism has been demonstrated in vitro between chloramphenicol, erythromycin, clindamycin and lincomycin. Chloramphenicol is rapidly absorbed from the GI tract. Chloramphenicol palmitate is hydrolyzed in the GI tract and is absorbed as free chloramphenicol.Following oral administration of a single one gram dose of chloramphenicol base to healthy adults, average peak plasma chloramphenicol concentrations of about 11 mcg/ml were attained with 1-3 hours. Cumulative dosing gave a peak of 18 mcg/ml after the fifth dose of one gram, every 6 hours. Mean serum levels were 8-14 mcg/ml over a 48 hour period.Most of the drug is excreted in the urine. Despite the small proportion of unchanged drug excreted in the urine, the concentration of free chloramphenicol in the urine is relatively high. From 8% to 12% of the antibiotic is excreted as free chloramphenicol. The remainder is excreted as inert metabolites, mainly glucuronate. Small amounts of active drug are found in bile and feces. Chloramphenicol diffuses rapidly, but its distribution is not uniform. Highest concentrations are found in liver and kidney, and lowest concentrations are found in brain and cerebrospinal fluid (CSF). Chloramphenicol enters CSF even in the absence of meningeal inflammation, appearing in concentrations about half of those found in the blood.

Pregnancy & Breastfeeding

Safety during pregnancy and breastfeeding hasn't been firmly established, so this medicine should be used only when a physician judges it truly necessary.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Chloramphenicol, like other potent medicines, should be given at the doses known to work effectively. Most sensitive organisms are inhibited at blood concentrations of 5 to 20 mcg/ml, and the aim is to keep the drug within this range for most of the treatment period. A dose of 50 mg/kg/day, divided into 4 doses given 6 hours apart, will usually reach and maintain levels in this range. Except in certain situations, such as premature infants, newborns, and people with liver or kidney impairment, lower doses may fail to reach these concentrations. Patients should be observed closely, and if any adverse reactions occur, the dose should be reduced or the drug stopped, provided the rest of the clinical picture allows this. Adults should receive 50 mg/kg/day in divided doses, roughly one 250 mg capsule for every 4.5 kg (10 lbs) of body weight, or one 500 mg capsule for every 9 kg (20 lbs) of body weight, split into doses given 6 hours apart. In exceptional cases, patients with infections caused by moderately resistant organisms may need a higher dose, up to 100 mg/kg/day, to reach blood levels that inhibit the organism, but such high doses should be lowered again as soon as possible. Adults with impaired liver or kidney function, or both, may be less able to metabolize and clear the drug, so doses should be adjusted accordingly in these cases. Pediatric patients: A dose of 50 mg/kg/day, divided into doses given 6 hours apart, is effective against most susceptible organisms. Severe infections, such as bloodstream infections or meningitis, particularly when adequate concentrations in the cerebrospinal fluid are needed, may require up to 100 mg/kg/day; however, the dose should be brought back down to 50 mg/kg/day as soon as possible. Children with impaired liver or kidney function may retain excessive amounts of the drug. Newborn infants: A total of 25 mg/kg/day, given in 4 equal doses 6 hours apart, usually produces and maintains concentrations in the blood and tissues adequate to control most infections for which the drug is used.

Side Effects & Interactions

Side Effects

No side-effect data recorded yet.