phenicol is a broad spectrum antibiotic for the treatment of bacterial conjunctivitis caused by
chloramphenicol susceptible organisms.
Consideration should be given to official guidance on the appropriate use of antibacterial
agents. Escherichia coli, Haemophilus influenzae, Staphylococcus aureus, Streptococcus
haemolyticus, Morax-Axenfeld, Klebsiella/Enterobacter species and others.
phenicol is indicated in adults and children.

Adults, children and infants: The recommended dosage for adults, children and infants of all
age groups is a small amount of the ointment to be applied to the affected eye every 3 hours or
more frequently if required. Treatment should be continued for 48 hours after the eye appears
normal.
Elderly: As for adults. phenicol has been used successfully at normal dosages in elderly
patients. The pattern and incidence of adverse effects does not appear to differ from younger
adults.
Pediatric population
Dosage adjustment may be necessary in newborn infants because of reduced systemic
elimination due to immature metabolism and the risk of dose-related adverse effects. The
maximum duration of treatment is 10-14 days.
Method of administration
Topical administration to the eye only.

The ointment must not be administered to: • Patients who have a history of hypersensitivity to chloramphenicol or to any of the excipients listed in section 6.1. • Patients who have experienced bone marrow suppression during previous exposure to chloramphenicol. • Patients with a known personal or family history of blood dyscrasias including aplastic anaemia.

Chloramphenicol is absorbed systemically from the eye and systemic toxicity has been
reported (see section 4.8).
Bone marrow hypoplasia, including aplastic anemia and death, has been reported following
topical use of Chloramphenicol. Whilst the hazard is a rare one, it should be borne in mind
when assessing the benefits expected from the use of the compound.
If the eye ointment is to be used on a long-term or intermittent basis, it may be advisable to
perform a routine blood profile before therapy and at appropriate intervals thereafter to detect
any haemopoietic abnormalities.
In severe bacterial conjunctivitis and in cases where infection is not confined to the
conjunctivae, the topical use of chloramphenicol should be supplemented by appropriate
systemic treatment.
Chloramphenicol does not provide coverage against Pseudomonas spp. or serratia
marcescens.
The use of topical chloramphenicol may occasionally result in overgrowth of non-susceptible
organisms including fungi. If any new infection appears during treatment, the antibiotic
should be discontinued and appropriate treatment given.
It is recommended that all types of contact lenses be avoided during ocular infections.
Do not use for more than 5 days without consulting a doctor.
Medical advice should be sought if there is no improvement in the condition after 2 days or if
symptoms worsen at any time.
Patients should be referred to their doctor if any of the following apply:
• Disturbed vision;
• Severe pain within the eye;
• Photophobia;
• Eye inflammation associated with a rash on the scalp or face;
• The eye looks cloudy;

• The pupil looks unusual;
• Suspected foreign body in the eye.
Patients should also be referred to their doctor if any of the following in his/her medical
history apply:
• Previous conjunctivitis in the recent past;
• Glaucoma;
• Dry eye syndrome;
• Eye surgery or laser treatment in the last 6 months;
• Eye injury;
• Current use of other eye drops or eye ointment;
If you wear contact lenses, seek advice either from your contact lens practitioner (optician,
optometrist) or doctor before you use this product. You should not wear your contact lenses
during the course of treatment. If you wear soft contact lenses do not start wearing them for at
least 24 hours after you have finished using the eye ointment.
The packaging will convey the following information:
• If symptoms do not improve within 48 hours talk to your doctor;
• Seek further immediate medical advice at any time if symptoms worsen.

None Known
If a concomitant topical treatment to the eye is required, the administration of the different
products should be separated by an adequate period of time.

The safety of topical chloramphenicol in pregnancy and lactation has not been established.
Chloramphenicol may be absorbed systemically following the use of eye ointment and may
cross the placenta and appear in breast milk. Therefore this product is not recommended for
use during pregnancy and lactation.

Blurring of vision can occur with the ointment and patients should be warned not to drive or
operate machinery unless their vision is clear.

Transient burning or stinging sensations may occur with the use of ophthalmic
chloramphenicol. Serious side effects include hypersensitivity reactions that may manifest as
angioneurotic oedema, anaphylaxis, urticaria, fever, and vesicular and maculopapular
dermatitis. Treatment must be discontinued immediately in such cases.

Bone marrow suppression, including the idiosyncratic type of irreversible and fatal aplastic
anaemia that is recognized to occur with systemic therapy, has been reported in association
with topical administration of chloramphenicol.

Accidental overdose or accidental ingestion of the ointment is unlikely to cause systemic
toxicity due to low content of chloramphenicol in the product.
If irritation, pain, swelling, lacrimation or photophobia occur after undesired eye contact, the
exposed eye(s) should be irrigated for at least 15 minutes. If symptoms persist after this, an
ophthalmological examination should be considered.

ATC Code: S01AA01
Pharmacotherapeutic group: Antibiotics
Mechanism of Action:-
Chloramphenicol exerts its antibacterial effect by binding to bacterial ribosomes and
inhibiting bacterial protein synthesis at an early stage.
Susceptibility:-
The following bacterial species are recognised conjunctival pathogens and may be susceptible
to chloramphenicol. However due to the prevalence of acquired resistance to chloramphenicol
in these species, the results of susceptibility testing should be taken into account as soon as
these are available. If no susceptibility test result is available, the choice of antibacterial agent
should be influenced by local information on the likely prevalence of resistance to
chloramphenicol in species that are commonly pathogenic in the eye.
Escherichia coli
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus pneumoniae
Other beta-haemolytic streptococci
Haemophilius influenzae
Moraxella catarrhalis
Neisseria gonorrhoeae
Resistance:-
Acquired resistance to chloramphenicol has been described in all the above species. Most
commonly this is mediated by bacterial production of a chloramphenicol acetyl transferase
that inactivates the drug. Chloramphenicol is not generally active against the
enterobacteriaceae and is not active against non-fermenters such as Pseudomonas aeruginosa.

Chloramphenicol is found in measurable amounts in the aqueous humour following local
application to the eye. Chloramphenicol may be absorbed systemically following the use of
eye ointment.

Pre-clinical safety data does not add anything of further significance to the prescriber.

White petrolatum
Paraffin oil
Lanolin alcohol

Not Applicable

2 years 28 days opened

Do not store above 30 °C

5 gm collapsible tubes from aluminum with plastic Nozzle for eye ointment and white cap.

Dispose of any unused ointment 28 days after opening the pack. Do not use if the pack is open
when supplied.