OVER the last several years, there has been increasing recognition of an apparent deleterious effect of chloramphenicol on vision in the form of an optic neuritis. Recognition of this entity has not produced any uniform suggestion for treatment or prevention of the neuritis other than minimal total dosage or withdrawal of chloramphenicol once toxic eye signs are noted.
Experience with a previously reported1 12-year-old girl with cystic fibrosis who developed an episode of chloramphenicol optic neuritis (CON) following prolonged use of the drug has led to the suggestion that pyridoxine (B6) or cyanocobalamin or both in very high daily doses may be of significant value in prevention of optic neuritis while the patient is receiving sustained chloramphenicol treatment.
Report of a Case
A 12-year-old girl with proved moderately severe cystic fibrosis (CF), developed an optic neuritis in January 1964 following total dosage of 135 gm chloramphenicol. From near
Cocke JG. Chloramphenicol Optic NeuritisApparent Protective Effects of Very High Daily Doses of Pyridoxine and Cyanocobalamin. Am J Dis Child. 1967;114(4):424–426. doi:10.1001/archpedi.1967.02090250122013