Pharmacology and toxicology
Chloramphenicol and thiamphenicol inhibit bacterial protein synthesis and have bacteriostatic activity.
Chloramphenicol is relatively toxic, and can cause severe agranulocytosis. It crosses the placenta well and can reach therapeutic concentrations in the fetus.
Sufficient experience with the use of chloramphenicol is available. There is no evidence that chloramphenicol increases the incidence of congenital malformations.
Chloramphenicol should not be used in the last weeks of prcgnancy as, owing to inadequate metabolism in the neonate, toxic concentrations can be reached which may cause the "gray baby syndrome" (feeding problems, vomiting, ash-gray skin, respiratory distress, and cardiovascular collapse), which may be fatal in the neonate.
2.6.12 Metronidazole and other nitroimidazole antibiotics
Recommendation. Chloramphenicol and thiamphenicol are contraindi-cated during pregnancy unless there is a serious indication. Treatment during the first trimester is not an indication for termination of pregnancy or for invasive prenatal diagnostic procedures.
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