title: Could chloramphenicol be used against ESKAPE pathogens? A review of in vitro data in the literature from the 21st century.
abstract: The widespread use of antibiotics has been associated with the emergence of antimicrobial resistance among bacteria. 'ESKAPE' (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acintobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.) pathogens play a major role in the rapidly changing scenario of antimicrobial resistance in the 21st century. Chloramphenicol is a broad spectrum antibiotic that was abandoned in developed countries due to its association with fatal aplastic anemia. However, it is still widely used in the developing world. In light of the emerging problem of multi-drug resistant pathogens, its role should be reassessed. Our paper reviews in vitro data on the activity of chloramphenicol against ESKAPE pathogens. Susceptibility patterns for Gram-positives were good, although less favorable for Gram-negatives. However, in combination with colistin, chloramphenicol was found to have synergistic activity. The risk-benefit related to chloramphenicol toxicity has not been analyzed. Therefore, extra precautions should be taken when prescribing this agent.
authors.affiliation: University of Zagreb School of Medicine, "Dr. Fran Mihaljević" University Hospital for Infectious Diseases, Mirogojska 8, 10 000 Zagreb, Croatia.
authors.forename: Rok
authors.initials: R
authors.lastname: Čivljak
authors.forename: Maddalena
authors.initials: M
authors.lastname: Giannella
authors.forename: Stefano
authors.initials: S
authors.lastname: Di Bella
authors.forename: Nicola
authors.initials: N
authors.lastname: Petrosillo
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology; D000741:Anemia, Aplastic / Q000139:chemically induced / Q000517:prevention & control; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002701:Chloramphenicol / Q000008:administration & dosage* / Q000009:adverse effects; D003091:Colistin / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D004754:Enterobacter / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology; D016984:Enterococcus faecium / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D002701:Chloramphenicol; D003091:Colistin