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Blepharitis - Management
What issues should I consider before prescribing topical antibiotics?
Chloramphenicol:
- Do not use topical chloramphenicol:
- In people who have experienced myelosuppression during previous exposure to chloramphenicol.
- In people who have a blood dyscrasia or who have a family history of blood dyscrasias.
- Concurrently with other myelotoxic drugs.
- In pregnant women (owing to the possibility of grey baby syndrome). However, it may be used in breastfeeding women [UKMiCentral, 2004].
- Topical chloramphenicol is relatively well tolerated. Aplastic anaemia and bone marrow depression are very rare, and concerns about the increased risk of this adverse effect are probably unfounded [Walker et al, 1998].
[ABPI Medicines Compendium, 2007a; ABPI Medicines Compendium, 2007b; BNF 54, 2007; ABPI Medicines Compendium, 2008]
Fusidic acid:
- People who wear contact lenses should avoid topical fusidic acid, as it contains preservatives (benzalkonium chloride).
- Topical fusidic acid has no reported serious adverse effects.
[ABPI Medicines Compendium, 2001; BNF 54, 2007]
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