Chloramphenicol therapy of typhoid fever

ABSTRACT

In a prospective study we compared two different dosage regimens of IV chloramphenicol succinate [100 mg/kg/day and 75 mg/kg/day] in children with culture proven typhoid. Trough and peak blood samples, obtained at 48 hrs, were analysed for free chloramphenicol by high pressure liquid chromatography [HPLC]. Although the mean trough [8.8 +/- 7.7 versus 5.4 +/- 2.6 mcg/ml] and peak [19.9 +/- 12.2 versus 15.4 +/- 6.1 mcg/ml] chloramphenicol concentrations were comparable in both groups, a significantly wider range was found in the group receiving 100 mg/kg/day. Potentially toxic levels [>30 mcg/ml] developed in two patients with liver dysfunction. Chloramphenicol in a dosage of 75 mg/kg/day is adequate and safe for the treatment of paediatric typhoid