Chloramphenicol: an impatient study of use and abuse

During a six-month period, chloramphenicol was administered systemically to 100 patients and topically to 24 patients who were admitted to the Medical Center Hospital of Vermont, Burlington, Vermont. Seventy-nine percent of the patients receiving the drug systemically were on surgical services, 13% were on the pediatric service, and 8% were on the medical service. In this group, chloramphenicol was administered appropriately in 60.4% of cases as follows: 57.5% on the surgical, 50% on the medical, and 84.6% on the pediatric services. In 19 of 35 instances of inappropriate use on the surgical services, a potentially less toxic antibiotic could have been chosen. Eight cases were treated inappropriately because of dosage errors, and in seven cases no antibiotic should have been used. On the medical services all inappropriate use was due to underdosage, and on the pediatric service there was one case of incorrect dosage and one instance in which a less toxic antibiotic could have been chosen. Ophthalmological use of the drug accounted for all topical use. Of 24 patients treated, 21 received the drug for prophylaxis and three for therapy.