Chloramphenicol worth the risk?

[Marrowforums]

Chloramphenicol is an antibiotic known to cause bone marrow failure yet renewed use of the drug is being proposed, according to a Los Angeles Times article.

Chloramphenicol was developed in the 1950s and was widely prescribed to fight bacterial infections before it became clear that patients were developing aplastic anemia or another bone marrow failure disease. Estimates of the incidence of bone marrow failure from chloramphenicol range from 12 to 100 people for each million users.

However, some scientists are proposing the use of chloramphenicol to treat methicillin-resistant Staphylococcus aureus (MRSA), a bacterial infection that killed an estimated 15,000 people in 2008. Because bacteria can develop resistance to modern drugs, it is thought that older antibiotic drugs may be more effective.

The proposed use of chloramphenicol would be as a last resort if patients with severe MRSA infections did not respond to antibiotics such as vancomycin (trade name Vancocin) and linezolid (trade name Zyvox). Pharmaceutical company Lannett plans to request FDA approval for this use of chloramphenicol. It is not clear what the FDA response will be.