"Gray baby syndrome"

studied to exclude a risk. An evidence-based evaluation of risk to the fetus is not currently possible for systemic use of chloramphenicol. There are concerns that use near term may be associated with a risk of neonatal Gray Baby Syndrome, however there are no well-documented cases of this occurring. Any risks to the fetus should be weighed against the potential adverse effects for the mother and fetus

and EffectsSummary of Use during LactationAdverse reactions such as vomiting, excessive intestinal gas and falling asleep at the breast have been reported in breastfed infants whose mothers were taking oral chloramphenicol. Milk concentrations are not sufficient to induce "gray baby" syndrome, but since chloramphenicol-induced aplastic anemia is not dose-related, this might occur, but has not been reported

, causes shock and possibly death from gray baby syndrome. In this example, the discrepancy in drug metabolism is due to decreased and altered hepatic elimination.For hepatically eliminated drugs, the neonate may have either a reduced or absent capacity for certain enzymatic degradation pathways. Thus, a drug that is metabolized by one enzymatic pathway in adults (eg, glucuronidation) may be metabolized

near term may be associated with a risk of neonatal Gray Baby Syndrome, however there are no well-documented cases of this occurring. Any risks to the fetus should be weighed against the potential adverse effects for the mother and fetus from an untreated infection.Exposure to ocular chloramphenicol at any stage in pregnancy would not usually be regarded as medical grounds for termination

, causes shock and possibly death from gray baby syndrome. In this example, the discrepancy in drug metabolism is due to decreased and altered hepatic elimination.For hepatically eliminated drugs, the neonate may have either a reduced or absent capacity for certain enzymatic degradation pathways. Thus, a drug that is metabolized by one enzymatic pathway in adults (eg, glucuronidation) may be metabolized

, causes shock and possibly death from gray baby syndrome. In this example, the discrepancy in drug metabolism is due to decreased and altered hepatic elimination.For hepatically eliminated drugs, the neonate may have either a reduced or absent capacity for certain enzymatic degradation pathways. Thus, a drug that is metabolized by one enzymatic pathway in adults (eg, glucuronidation) may be metabolized

, causes shock and possibly death from gray baby syndrome. In this example, the discrepancy in drug metabolism is due to decreased and altered hepatic elimination.For hepatically eliminated drugs, the neonate may have either a reduced or absent capacity for certain enzymatic degradation pathways. Thus, a drug that is metabolized by one enzymatic pathway in adults (eg, glucuronidation) may be metabolized

, causes shock and possibly death from gray baby syndrome. In this example, the discrepancy in drug metabolism is due to decreased and altered hepatic elimination.For hepatically eliminated drugs, the neonate may have either a reduced or absent capacity for certain enzymatic degradation pathways. Thus, a drug that is metabolized by one enzymatic pathway in adults (eg, glucuronidation) may be metabolized

women and young children for whom doxycycline is contraindicated.Single-dose azithromycin can be used for prophylaxis of MSF following a tick bite in an endemic area. [33] Chloramphenicol is an acceptable alternative but adverse drug reactions, particular blood dyscrasias and gray baby syndrome in pregnancy, and lack of commercial availability in the United States limit its use.Fluoroquinolones may

women and young children for whom doxycycline is contraindicated.Single-dose azithromycin can be used for prophylaxis of MSF following a tick bite in an endemic area. [33] Chloramphenicol is an acceptable alternative but adverse drug reactions, particular blood dyscrasias and gray baby syndrome in pregnancy, and lack of commercial availability in the United States limit its use.Fluoroquinolones may

associated with gray baby syndrome in newborns but no teratogenic effects. It may be used in pregnancy to treat Rocky Mountain spotted fever if a 2nd-line agent is required, but caution is warranted in the 3rd trimester. Chloramphenicol enters breast milk. It should not be used during breastfeeding; serious adverse reactions are possible, particularly in young or low weight infants. Adverse Effects of Chloramphenicol Adverse effects of chloramphenicol include * Bone marrow depression (most serious) * Nausea, vomiting, and diarrhea * Gray baby syndrome (in neonates) There are 2 types of bone marrow depression: * Reversible dose-related interference with iron metabolism: This effect is most likely with high doses or prolonged treatment or in patients with a severe liver disorder

or fetal damage.Cephalosporins are generally considered safe.Chloramphenicol, even in large doses, does not harm the fetus; however, neonates cannot adequately metabolize chloramphenicol, and the resulting high blood levels may lead to circulatory collapse (gray baby syndrome). Chloramphenicol is rarely used in the US.Fluoroquinolones are not used during pregnancy; they tend to have a high affinity

hematological adverse events such as aplastic anemia, gray baby syndrome and hemolytic anemia in patients with the Mediterranean form of G6PD deficiency). We conducted two randomized clinical trials; the first compared clarithromycin versus chloramphenicol: mean time to defervescence was 36.7 +/- 18.1 h in the clarithromycin group and 47.1+/- 21.9 h in the chloramphenicol group (P= 0.047). The second trial

Nervous system * Perinatal asphyxia * Periventricular leukomalacia Musculoskeletal * Gray baby syndrome