Topical administration of chloramphenicol can induce acute hepatitis

doi:10.1136/bmj.b1699

Published 12 June 2009, doi:10.1136/bmj.b1699
Cite this as: BMJ 2009;338:b1699

Practice

Drug Point

Topical administration of chloramphenicol can induce acute hepatitis

B Doshi, advanced endoscopy fellow , S Sarkar, consultant gastroenterologist

¹ Aintree Centre for Gastroenterology, University Hospitals Aintree, Liverpool

Correspondence to: Dr B Doshi, consultant gastroenterologist, National University Hospital, Singapore bdoshi8@yahoo.co.uk

The first 150 words of the full text of this article appear below.

We report a case of drug induced hepatitis attributable to conjunctivaladministration of chloramphenicol. Although hepatobiliary complicationsresulting from systemic chloramphenicol have been described,¹such reactions after topical application have not been reportedin adults.

A 37 year old male engineer was treated for conjunctivitis with0.5% chloramphenicol eye drops (one drop in each eye every twohours for 24 hours followed by one drop every six hours forfour days) as suggested by the BNF.² He complained of lethargy,pruritus, dark urine, and icteric sclera seven days after completingthe course of eye drops. His only other concurrent medicationwas a regular proton pump inhibitor (rabeprazole 20 mg oncedaily), which was started three years before he developed symptomsand was not stopped during the course of his illness. He hadno history of using over the counter antihistamines or analgesics,taking chloramphenicol previously, or chemical exposure at . . . [Full text of this article]