What is a potential severe adverse effect of chloramphenicol?

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Chloramphenicol is associated with a notable risk of aplastic anemia, which is a severe and potentially life-threatening condition characterized by the failure of bone marrow to produce adequate amounts of blood cells. This side effect is particularly concerning because it can occur even after short-term use of the drug, making it a significant consideration when prescribing chloramphenicol. Aplastic anemia can lead to severe complications such as infections due to low white blood cell counts and bleeding due to low platelet levels.

Chloramphenicol's mechanism of action, which involves inhibiting protein synthesis in bacteria, does not directly explain the occurrence of aplastic anemia; however, it is thought that chloramphenicol can cause an immune-mediated response or direct damage to hematopoietic progenitor cells in the bone marrow. This risk necessitates regular monitoring of blood counts during treatment, especially when the drug is used in populations at higher risk or for extended durations.

While nephrotoxicity, hepatotoxicity, and ototoxicity can be adverse effects associated with other antibiotics, chloramphenicol is distinctly notable for its association with aplastic anemia, underscoring the importance of evaluating potential risks when considering antibiotic therapy.

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