Chloramphenicol: Uses, Risks, and What You Need to Know

When you hear chloramphenicol, a broad-spectrum antibiotic used for severe bacterial infections when other drugs fail. Also known as Chloromycetin, it’s one of the oldest antibiotics still in use today, but it’s rarely the first choice because of its dangerous side effects. This drug kills bacteria by stopping them from making proteins—essentially shutting down their ability to reproduce. It works against a wide range of infections, from eye infections to meningitis, but it’s not a casual pick. In fact, many doctors avoid it unless absolutely necessary.

Chloramphenicol is still used in eye drops and ointments for bacterial conjunctivitis because the risk stays low when applied locally. But when taken by mouth or injected, it can cause a rare but deadly condition called aplastic anemia—where the bone marrow stops making blood cells. This isn’t a common side effect, but when it happens, it’s often permanent or fatal. That’s why the FDA limits its use in the U.S. to life-threatening infections where no safer option exists. It’s also banned in food animals because residues can end up in meat and milk, putting the public at risk.

Another big concern is antibiotic resistance, the growing problem where bacteria evolve to survive antibiotic treatment. Chloramphenicol was one of the first antibiotics to face widespread resistance. Today, many common infections no longer respond to it, making it less useful for routine cases. Still, in low-resource settings or for rare infections like typhoid fever in areas with limited drug access, it remains a critical tool. It’s also used in veterinary medicine for pets and livestock, though regulations are tightening everywhere.

People taking chloramphenicol need close monitoring—blood tests are often required to catch early signs of bone marrow damage. Even a short course can trigger problems, especially in newborns, who can develop "gray baby syndrome," a life-threatening condition caused by their underdeveloped liver’s inability to process the drug. That’s why it’s rarely given to infants unless there’s no alternative.

What you’ll find below is a collection of real-world stories and science-backed guides that connect to chloramphenicol’s role in modern medicine. You’ll see how it fits into broader discussions about antibiotic side effects, the hidden dangers of powerful drugs used to treat infections, how bacterial infections, conditions caused by harmful bacteria that require targeted treatment are managed when first-line drugs fail, and why some medications stay in use despite their risks. These aren’t just technical articles—they’re practical insights for anyone who’s ever wondered why a doctor chose one drug over another, or why some treatments come with so many warnings.