Quantitative chloramphenicol detection in serum and cerebrospinal fluid of infants with bacterial meningitis

Twenty-six meningitic infants aged less than one year were administered daily oral or intravenous doses from 44 to 170 mg chloramphenicol per kg body weight. Serum levels measured were 5.4 to 55.0 micrograms.ml-1, and CSF concentrations from 0.9 to 20.2 micrograms.ml-1 were noted. Since, in particular for younger infants, (i) there is no clear relationship between dose and blood level and (ii) one cannot unambiguously infer the CSF concentration from the blood level we recommend that initial doses for meningitic infants be chosen according to age-adjusted dosage instructions and, from day 2 onwards, doses be corrected as a function of CSF and blood levels (CSF greater than 10 micrograms.ml-1 and serum less than 50 micrograms.ml-1).