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Chloramphenicol levels

This is a reference laboratory investigation – tests performed in Southmead Hospital (NBT) Microbiology Department. Antimicrobial Reference Laboratory. The information given here is intended for use by healthcare professionals. We recommend monitoring chloramphenicol levels in all patients who are being treated with chloramphenicol for suspected or confirmed bacterial meningitis There may be other circumstances when chloramphenicol levels may be useful – please discuss any other requests with the duty Consultant Microbiologist

The information given here is intended for use by healthcare professionals. Please see Lab Tests Online-UK for more general advice, links and background.

Sample requirements and clinical information

  • Patient name, sex and age
  • Dosage, frequency and timing of samples
  • Time of dose in relation to the samples
  • Clinical Summary. It would be useful to be informed of any β-lactam therapy.
  • Appropriate hazard warnings – eg known positive BBV status

Storage/transport

  • Do not store. Send at ambient temperature to the laboratory as soon as possible.
  • Chloramphenicol is degraded by light; please ensure the samples are protected from direct sunlight

Advance warning

We recommend that you take chloramphenicol levels on weekdays – this is for logistical reasons.

Please contact the serology laboratory (extension 5072) on a weekday, in advance, to discuss the possibility of the sample being taken and the test being performed on Saturdays, Sundays and bank holidays.

Please note that chloramphenicol levels are a reference laboratory investigation with sample transportation from GRH Microbiology Lab being arranged to the testing laboratory at Southmead Hospital.

Sample required

Container: Serum (Gold top)

For adults

  • 5.0 mL of blood taken into a gold topped gel tube

The testing lab need approximately 1-2 mL of separated serum (the minimum acceptable is 100 µL).

Leaking samples may not be processed

Full size

Timing of samples

We recommend taking paired pre and 2 hour post-dose samples:

pre dose sample

and a

2 hour post dose sample (taken 2 hours after the end of either iv administration or oral administration)

We recommend taking the first pair of chloramphenicol levels when the patient has been on treatment for a minimum of 48 hours.

Normal (target) levels

Pre dose <10 mg/L

Post dose (2h) 10-25 mg/L

Result interpretation

If there is any doubt regarding interpretation, or a dose change needs to be discussed, then please contact the Consultant Microbiologist

Re-assay interval

5 to 7 days, assuming initial results are within expected range.

Turnaround time

This is reference laboratory investigation - the turnaround time is affected by time taken to transport the sample to the testing lab (from the clinical area) and the turnaround time of the reference laboratory. The reference lab normally only routinely performs chloramphenicol levels on weekdays. Southmead’s turnaround time, once the sample is in their laboratory, is < 3 days.

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