Last update Feb. 26, 2018

Chloramphenicol (topical use)

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Topically used to treat cutaneous, eye and ear infections.

The small dose used and poor plasma uptake of most topical ophthalmic and dermal preparations make it very unlikely that a significant amount would pass into breast milk.
Plasma levels after topical application on skin are 1000 times lower than those observed after systemic administration (Fluhr 1998).
Possible absorption following ophthalmologic administration could be minimized by following appropriate ophthalmologist instructions (eg finger-compression on the tear sac at the internal eye’s corner for one minute after application of drops)
Even after been taken systemically (orally or parenterally), the excretion into breastmilk is poor, which would impede the development of neonatal gray syndrome.

Do not apply on the chest to prevent the infant from ingesting it. Otherwise, apply it after a breast feeding and clean it up thoroughly with water before the next feeding.

Alternatives

  • Gentamicin Sulfate (Safe substance and/or breastfeeding is the best option.)
  • Tobramycin (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Groups

Chloramphenicol (topical use) belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Chloramphenicol (topical use) in its composition:

List of 25 tradenames

Pharmacokinetics

Variable Value Unit
Oral Bioavail. Dermat: ≅ 0 %
Molecular weight 323 daltons
Protein Binding 53 - 60 %
T½ 1.5 - 4 hours

References

  1. Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006 Abstract
  2. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001 Feb;17(1):54-65. Abstract
  3. Fluhr JW, Gloor M, Merkel W, Warnecke J, Höffler U, Lehmacher W, Glutsch J. Antibacterial and sebosuppressive efficacy of a combination of chloramphenicol and pale sulfonated shale oil. Multicentre, randomized, vehicle-controlled, double-blind study on 91 acne patients with acne papulopustulosa (Plewig and Kligman's grade II-III). Arzneimittelforschung. 1998 Abstract
  4. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5(2):57-60. Abstract
  5. Plomp TA, Thiery M, Maes RA. The passage of thiamphenicol and chloramphenicol into human milk after single and repeated oral administration. Vet Hum Toxicol. 1983 Abstract
  6. Burke JT, Wargin WA, Sherertz RJ, Sanders KL, Blum MR, Sarubbi FA. Pharmacokinetics of intravenous chloramphenicol sodium succinate in adult patients with normal renal and hepatic function. J Pharmacokinet Biopharm. 1982 Abstract
  7. Nahata MC, Powell DA. Bioavailability and clearance of chloramphenicol after intravenous chloramphenicol succinate. Clin Pharmacol Ther. 1981 Abstract
  8. Abrams SM, Degnan TJ, Vinciguerra V. Marrow aplasia following topical application of chloramphenicol eye ointment. Arch Intern Med. 1980 Abstract
  9. Koup JR, Lau AH, Brodsky B, Slaughter RL. Chloramphenicol pharmacokinetics in hospitalized patients. Antimicrob Agents Chemother. 1979 Abstract Full text (link to original source) Full text (in our servers)
  10. Trope GE, Lawrence JR, Hind VM, Bunney J. Systemic absorption of topically applied chloramphenicol eyedrops. Br J Ophthalmol. 1979 Abstract
  11. Havelka J, Hejzlar M, Popov V, Viktorinová D, Procházka J. Excretion of chloramphenicol in human milk. Chemotherapy. 1968 Abstract

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