Editing Chloramphenicol (section)

===Aplastic anemia===

The most serious [[adverse drug reaction|side effect]] of chloramphenicol treatment is [[aplastic anaemia|aplastic anaemia ('AA')]]. This effect is rare but sometimes fatal. The risk of AA is high enough that alternatives should be strongly considered. Treatments are available but expensive. No way exists to predict who may or may not suffer this side effect. The effect usually occurs weeks or months after treatment has been stopped, and a genetic predisposition may be involved. It is not known whether monitoring the [[blood count]]s of patients can prevent the development of aplastic anaemia, but patients are recommended to have a baseline blood count with a repeat blood count every few days while on treatment.<ref>{{cite journal | vauthors = Hammett-Stabler CA, Johns T | title = Laboratory guidelines for monitoring of antimicrobial drugs. National Academy of Clinical Biochemistry | journal = Clinical Chemistry | volume = 44 | issue = 5 | pages = 1129–1140 | date = May 1998 | pmid = 9590397 | doi = 10.1093/clinchem/44.5.1129 | doi-access = free }}</ref> Chloramphenicol should be discontinued if the complete blood count drops. The highest risk is with oral chloramphenicol (affecting 1 in 24,000–40,000)<ref>{{cite journal | vauthors = Wallerstein RO, Condit PK, Kasper CK, Brown JW, Morrison FR | title = Statewide study of chloramphenicol therapy and fatal aplastic anemia | journal = JAMA | volume = 208 | issue = 11 | pages = 2045–2050 | date = June 1969 | pmid = 5818983 | doi = 10.1001/jama.208.11.2045 }}</ref> and the lowest risk occurs with eye drops (affecting less than one in 224,716 prescriptions).<ref name="Lancaster1998"/>