Chloramphenicol in Typhoid Fever

Patel, Jignesh; Banker, D. D.; Modi, Chintan

doi:10.1136/bmj.2.4633.908

Cited by 22 publications

(1 citation statement)

References 3 publications

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“…Chloramphenicol (or chloromycetin as it was called initially) was first isolated for therapeutic purposes by Ehrlich et al in 1947 (Ehrlich et al 1947; see in the same edition: Smadel and Jackson 1947). A year after its isolation it proved to be quite effective against typhoid fever (Patel et al 1949). Apart from being used as human medication, chloramphenicol also has an extensive track record in animal food production.…”

Section: Example 2 – Chloramphenicolmentioning

confidence: 99%

Of Reductionism and The Pendulum Swing: Connecting Toxicology and Human Health

Hanekamp

Bast

Kwakman³

2011

Dose-Response

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In this contribution we will show that research in the field of toxicology, pharmacology and physiology is by and large characterised by a pendulum swing of which the amplitudes represent risks and benefits of exposure. As toxicology usually tests at higher levels than the populace routinely is exposed to, it reverts to mostly linear extrapolative models that express the risks of exposure, irrespective of dosages, only. However, as we will explicate in two examples, depending on dosages, it is less easy to separate risks and benefits than current toxicological research and regulatory efforts suggest. The same chemical compound, in the final analysis, is represented within the boundaries of both amplitudes, that is, show a biphasic, hormetic, dose-response. This is notable, as low-level exposures from the food-matrix are progressively more under scrutiny as a result of increasing analytical capabilities. Presence of low-level concentrations of a chemical in food is a regulatory proxy for human health, but in light of this hormetic dose-response objectionable. Moreover, given that an ecological threshold probably holds for most, if not all, man-made (bio)organic chemicals, these will be found to be naturally present in the food matrix. Both aspects require toxicology to close the gap between reductionist models and its extrapolative deficiencies and real-life scenarios.

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Section: Example 2 – Chloramphenicolmentioning

confidence: 99%

Of Reductionism and The Pendulum Swing: Connecting Toxicology and Human Health

Hanekamp

Bast

Kwakman³

2011

Dose-Response

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TREATMENT OF TYPHOID IN CHILDREN WITH CHLORAMPHENICOL (CHLOROMYCETIN®)<subtitle>Report of Seven Cases</subtitle>

Greengard¹

1951

Arch Pediatr Adolesc Med

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Fatal Cardiovascular Collapse of Infants Receiving Large Amounts of Chloramphenicol

Sutherland¹

1959

Arch Pediatr Adolesc Med

116

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Death of three newborn infants (without obvious immediate cause of death at necropsy) followed administration of moderately large amounts of chloramphenicol.The recommended intramuscular dose of the microcrystalline suspension of chloramphenicol in aqueous vehicle was 100 to 150 mg. per kilogram of body weight per day for children of 15 kg. or less.1-3 One death occurred after administration of 220 mg. per kilogram per day for 60 hours.Another death occurred after administration of 230 mg. per kilogram per day for 72 hours. The recommended oral dose of the suspension of chloramphenicol palmitate for children of 15 kg. or less was 50 to 100 mg. per kilogram per day4 up to 100 to 150 mg. per kg. per day.3,5 One death occurred after 50 mg. per kilogram per day for 56 hours and 10 hours after a single inadvertent oral dose of 400 mg.The use of doses of chloramphenicol of the size recorded here has not been reported previously in newborn infants, and there has been little opportunity to observe pos¬ sible adverse effects of such large amounts.Because of the wide antibacterial spectrum of chloramphenicol, the drug has been ex¬ tremely useful. It is considered to be well tolerated and nontoxic, at least over short periods of time. Report of these possible adverse results of chloramphenicol therapy may permit other more definitive and bet¬ ter-controlled observations and indirectly result in a more rational application of a useful chemotherapeutic agent to the new¬ born infant with bacterial infection. Report of CasesCase 1.-The infant was a 3,440 gm. boy, born ' of a 33-year-old white married Gr. V, Group A, Rh+ mother with negative serologie test for syphilis at 40 weeks' gestation. During pregnancy the mother had a blood pressure of 140/80, and complained of edema and visual disturbances. Two previous pregnancies had resulted in spontaneous abortions at 12 and 6 weeks. The first two preg¬ nancies terminated at 40 weeks with delivery of normal infants.By history, membranes ruptured one week before delivery. The infant was delivered spontaneously by cephalic presentation 20 minutes after 100 mg. of meperidine (Demerol) hydrochloride, 1 mg. of levallorphan lartrate (Lorfan), and 1/150 grain (0.4 mg.) of scopolamine, and 4l/2 hours after onset of labor. Agar score was 10.Initial examination of the infant revealed no abnormalities. Menadione sodium bisulfite, 5 mg., was given, and, because of the premature rupture of the maternal membranes, 50,000 units of pro¬ caine penicillin and 50 mg. of streptomycin intra¬ muscularly every 12 hours were ordered. At 8 to 10 hours of age the infant went to breast and fed well. On the second day he was circumcised.At 3 days of age, jaundice was noted and there was periumbilical erythema which extended in a 13/761

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Chloramphenicol in Typhoid Fever

Cited by 22 publications

References 3 publications

Of Reductionism and The Pendulum Swing: Connecting Toxicology and Human Health

Of Reductionism and The Pendulum Swing: Connecting Toxicology and Human Health

TREATMENT OF TYPHOID IN CHILDREN WITH CHLORAMPHENICOL (CHLOROMYCETIN®)<subtitle>Report of Seven Cases</subtitle>

Fatal Cardiovascular Collapse of Infants Receiving Large Amounts of Chloramphenicol

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