Re: over the counter chloramphenicol


Ann wrote:
> On Mon, 28 Nov 2005 23:52:06 GMT, "Mike Tyner" <mtyner@xxxxxxxxxxxxxx>
> wrote:
>
> >
> >"Ann" <me@xxxxxxxxxxx> wrote
> >
> >> So do the professionals think this is a good move or not? Do the
> >> public know when they need antibiotics or is it best left to the
> >> doctor? This applies to the UK. What is the position in the US?
> >
> >Chloramphenicol is shunned in the US because of a (questionable) association
> >with aplastic anemia. I don't think it's a real risk when used topically in
> >the eye.
>
> Yes. It's no longer used here as an oral medication because of that
> reason.
>
> >Antibiotics are essentially no help for viral infections, and most "pink
> >eye" episodes are viral, not bacterial.
>
> That is what they are saying here. That the patient doesn't know if
> the infection is caused by a virus or bacteria but then neither does
> the doctor. They generally don't do culture and sensitivity tests
> unless the condition continues. The doctor will say that
> super-infection by a bacteria is always possible and that is why they
> give the antibiotics.
>
> Ann
>
> >That doesn't stop US doctors from handing out Vigamox and Tobrex for
> >pinkeye.
> >
> >-MT

In pharmacology I was taught that because of its association with
aplastic anemia, chloramphenicol should only be used in life
threatening infections. Because of that, I have never used it in
clinical practice, and never felt the need to challenge that
association because of the availability of other antibiotics.
Polysporin has always been available OTC, and there are few topical
antibiotics more effective than polysporin (bacitracin and polymyxin
B).

A secondary bacterial infection often occurs along with a viral
infection. Also, in the U.S. the rules of the game are such that
children are sent home with any type of eye infection, no matter how
benign. This puts the onus on the doctor to "treat" in order to get
the child back to school ASAP.

I doubt that a viral infection is of much concern to an enucleated eye.

DrG

.

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