In addition to the serious and potentially fatal
bone marrow depression that can occur with
chloramphenicol, it may also cause a milder, reversible
bone marrow depression, which can oppose the treatment of
anaemia with
iron.
It has been suggested that
chloramphenicol dosages of 25 to 30 mg/kg are usually adequate for treating infections without running the risk of elevating
serum levels to 25 micrograms/mL or more, which is when this type of marrow
depression can occur. Monitor the effects of using
iron concurrently. Where possible it would be preferable to use a different antibacterial.