Evaluation of Chloramphenicol Acid Succinate Therapy of Induced Typhoid Fever and Rocky Mountain Spotted Fever

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Abstract
In volunteers with induced typhoid fever, plasma levels of free biologically active chloramphenicol were approximately twice as high in those treated with oral chloramphenicol (four subjects) as in those treated with the same dose of intramuscular chloramphenicol succinate (four subjects), apparently owing to the failure of the intramuscularly administered succinate ester to be completely hydrolyzed to the active drug. Plasma chloramphenicol levels in nine volunteers infected with Rocky Mountain spotted fever and treated with chloramphenicol succinate intramuscularly revealed that approximately a third of the administered drug was present in the biologically inactive unhydrolyzed form. Although chloramphenicol succinate was effective in controlling the early toxicity of induced typhoid fever and Rocky Mountain spotted fever, the delayed response and high relapse rate made this preparation inadequate as the sole form of therapy given intramuscularly in conventional doses.

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