Chloramphenicol for eye infections

Name of medicine

Chloramphenicol

Brand names: Chloromycetin Redidrops (eye drops), Chloromycetin eye ointment, Minims Chloramphenicol (eye drops)

Why is it important for my child to take Chloramphenicol?

Chloramphenicol is an antibiotic. By giving the eye medicine regularly in the way that your doctor has told you to, it should kill the harmful bacteria and get rid of your child’s infection.

What is Chloramphenicol available as?

• Eye drops (0.5% chloramphenicol)
• Eye ointment (1% chloramphenicol)

When should I give Chloramphenicol

Eye drops

• Give four times a day. This is usually first thing in the morning, at about midday, late in the afternoon and at bedtime. Ideally these times should be at least 4 hours apart (e.g. 8 am, midday, 4 pm, 8 pm).
• If the infection is severe, your doctor may tell you to use the drops every 2 hours for the first 48 hours.
• Your doctor may give you ointment to use at bedtime instead of drops.

Eye ointment

• Apply four times a day. This is usually first thing in the morning, at about midday, late in the afternoon and at bedtime. Ideally these times should be at least 4 hours apart (e.g. 8 am, midday, 4 pm, 8 pm).

Continue to give the drops or ointment four times a day for 3 days after all signs of the infection have gone.

Give chloramphenicol at about the same times each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of Chloramphenicol (the dose) that is right for your child. The dose will be shown on the medicine label.

How should I give Chloramphenicol?

• Use the drops or ointment only in the infected eye, unless your doctor has told you to treat both eyes.
• Wash your hands thoroughly with soap and hot water before and after giving the drops or ointment.
• The drops or ointment are easiest to give when your child is lying down.
• You may need help from another adult to help give eye medicine, especially in small children and babies. One of you can hold the child still and one can give the drops or ointment. You may find it helpful to wrap a small child or baby in a blanket to help keep them still.

• For older children, gently pull the lower lid out and squeeze the bottle gently so that one drop goes into the pocket that is formed.
• In small children and babies, place the drop into the inner corner of the eye. This is easier with the eye open, but the liquid will still drain on to the eye even with a closed eye if you can hold your child’s head still for a few seconds.
• After giving eye drops, your child should keep their eye closed for as long as they can (5 seconds if possible) so that the eye drop doesn’t spill out.
• If you think the drop didn’t go into the eye, you can repeat the process but do not try more than twice.
• Try to avoid the tip of the tube touching any part of your child’s eye, if possible.
• Wash your hands again with soap and hot water

• For older children, gently pull the lower lid out and down and squeeze the tube gently so that a small amount (approximately 1 cm) goes into the pocket that is formed.
• In small children and babies, place the ointment into the inner corner of the eye, preferably with the eye open.
• After giving the ointment, your child should blink several times to help dissolve the ointment.
• If you think the ointment didn’t go into the eye, you can repeat the process but do not try more than twice.
• Try to avoid the tip of the tube touching any part of your child’s eye, if possible.
• Wash your hands again with soap and hot water.

When should the medicine start working?

The medicine will start to work straight away but it may take 2–3 days before your child starts to feel better.

It is important that you give the whole course of Chloramphenicol that your doctor has prescribed, even when your child feels better. This is to make sure that all the bacteria are killed and the infection doesn’t come back.

What if I forget to give it?

Give the next dose as soon as you remember but make sure there is at least 2 hours between each application.

What if I give too much?

You are unlikely to cause harm if you give an extra dose of Chloramphenicol by mistake. If you are concerned that you may have given too much, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging with you if you telephone for advice.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Your child’s eyes may sting a little with the first few doses. Other side-effects are unlikely with chloramphenicol eye drops/ointment. If you notice anything unusual and are concerned, contact your doctor.

Can other medicines be given at the same time as Chloramphenicol?

• You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Is there anything else I need to know about this medicine?

• If your child rubs the infected eye, they should wash their hands, so that they don’t transfer the infection to the other eye.
• Children should not wear contact lenses during treatment with eye drops or ointment because the preservatives can cause irritation.
• If someone swallows eye drops of ointment by accident, it is unlikely to do harm.
• If your child is using other eye drops/ointments, try to space them out during the course of the day, and do not give at the same time (unless recommended).
• Once opened, chloramphenicol eye drops/ointment should not be kept for longer than 4 weeks.
• Only give these drops/ointment to your child for their current infection. Do not save the medicine for future infections. Give old or unused drops/ointment to your pharmacist to dispose of.

General advice about medicines

• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

• If you think someone else may have taken the medicine by accident, contact your doctor for advice.

• If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.

General advice about antibiotics

• It is important that your child completes the course of antibiotic. This means that they must take the medicine for the number of days that the doctor has told you to, or until all of the medicine has been taken. If you stop giving the antibiotic too soon, the bacteria that are left will start to multiply again, and may cause another infection. There is also a risk that these bacteria will be ‘resistant’ to the first antibiotic. This means that it might not work next time, and your child might need a different antibiotic, which might not work as well or cause more side-effects.
• Try to give the medicine at about the same times each day, to help you remember, and to make sure that there is the right amount of medicine in your child’s body to kill the bacteria.
• Only give this medicine to your child for their current infection.
• Never save medicine for future illnesses. Give old or unused antibiotics to your pharmacist to dispose of.
• Antibiotics only kill bacteria; they do not kill viruses. This means that they do not work against colds, sore throats, flu or other infections that are caused by viruses. Your doctor will not prescribe antibiotics for these illnesses.

Where should I keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight.

• Eye drops can be kept in a cupboard for up to 7 days but it is better to keep them in a fridge. Make sure that the medicine doesn’t freeze. The drops should be taken out of the fridge 2 hours before using them, so that they do not sting.

• Make sure that children cannot see or reach the medicine.

• Keep the medicine in the container it came in.

Who to contact for more information?

Your child’s doctor, pharmacist or nurse will be able to give you more information about Chloramphenicol and about other medicines used to treat infections.

Copyright disclaimer

Version [1]. © NPPG, RCPCH and WellChild, all rights reserved. Review by November 2015.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.