Klorfen Adverse Reactions

The most serious effect of chloramphenicol is its depression of the marrow which can take two different forms. The first reversible is characterized by morphological changes in the bone marrow, decreased iron utilization, reticulocytopenia, anaemia, leucopenia and thrombocytopenia. All these abnormalities return to normal 2-3 weeks after cessation of therapy.
The second is severe irreversible aplastic anaemia which is fairly rare with an incidence estimated to be 1 case per 4000 courses of therapy. Mortality is approximately 50%. Those who survive may have a higher incidence of leukemia. Haemolytic anaemia has occurred in some persons with a genetic deficiency of glucose-6-phosphate dehydrogenase activity.
In neonates, especially prematures and in young infants, overdose of chloramphenicol may lead to Gray baby syndrome. The syndrome occurs because of defective ability to conjugate the drug in neonates. Three to four days after initiation of therapy, abdominal distension, vomiting, respiratory difficulty, pale cyanotic skin, hypotension and metabolic acidosis followed by cardiovascular collapse occurs.
Peripheral as well as optic neuritis has been reported in patients receiving chloramphenicol usually over prolonged periods.