Q: Why Chloramphenicol is not first-line therapy in treatment of meningitis?
Answer: As it is not a bactericidal antibiotic and only has bacteriostatic characteristics
Chloramphenicol despite achieving high concentration in cerebrospinal fluid (CSF) usually has a high failure rate. This is due to its bacteriostatic characteristic. The organism may not only persists but chloramphenicol-resistant organisms also may emerge during the treatment. It should be used when no other viable choices are available.
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References:
1. Landesman SH, Cherubin CE, Corrado ML. Gram-negative bacillary meningitis. New therapy and changing concepts. Arch Intern Med 1982; 142:939.
2. Levitz RE, Quintiliani R. Trimethoprim-sulfamethoxazole for bacterial meningitis. Ann Intern Med 1984; 100:881.
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