Chloramphenicol 1. Hazards of use and the current regulatory environment

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Abstract
Chloramphenicol is a broad-spectrum antibiotic which has enjoyed extensive use in both medical and veterinary practice. Shortly after its introduction in the late 1940s, the use of chloramphenicol was associated with the induction of an idiosyncratic form of aplastic anaemia in man. This rare and unpredictable adverse effect has since been associated not only with systemic use but with topical applications, as well as occupational exposure. Recognition of the small risk of a potentially fatal adverse reaction, together with the risk of selection of chloramphenicol-resistant pathogens, has led to restrictions on the veterinary uses of chloramphenicol. In Australia at present, the use of chloramphenicol is only permitted in small animals. Its use is specifically prohibited in food-producing animals, including horses.