Metabolism of chloramphenicol: a story of nearly 50 years

Effects of chloramphenicol on brain energy metabolism using 31P spectroscopy: influences on sleep-wake states in rat

Effects of chloramphenicol (antibiotic inhibiting complex-1 of respiratory chain) and thioamphenicol (TAP, a structural analog of CAP inactive on complex-1) were examined on cerebral energy metabolites and sleep-wake cycle architecture in rat. In the first group, animals were chronically equipped with a cranial surface resonator and (31)P spectroscopic measurements were performed using a 2 T magnetic resonance spectrometer (operating frequency 34.46 MHz). CAP administration (400 mg/kg, tail vein, light period) induced deficits in phosphocreatine (-30%, p < 0.01) and ATP (-40%, p < 0.01), whereas TAP (400 mg/kg) had no effect. In the second group, animals were chronically implanted with polygraphic electrodes for EEG and electromyogram recordings. CAP administered intraperitoneally at light-onset reduced rapid-eye movement (REM) sleep (-60% in the first 6 h of light period, p < 0.01), increased waking state (+65% in the first 6 h of light period, p < 0.01), and slightly affected slow-wave sleep (SWS). During waking state, theta and sigma power bands of the EEG were, respectively, increased and decreased (p < 0.05). During SWS, delta power band was reinforced (p < 0.05), while theta, alpha, and sigma bands were decreased (p < 0.05). No changes occurred during REM sleep. TAP had no effect on sleep-wake states and spectral components of the EEG. Overall, these data indicate that REM sleep occurrence is linked to an aerobic production of ATP.

Inhibition of NADH oxidation by chloramphenicol in the freely moving rat measured by picosecond time-resolved emission spectroscopy

Owing to the lack of methods capable to monitor the energetic processes taking place within small brain regions (i.e. nucleus raphe dorsalis, nRD), the neurotoxicity of various categories of substances, including antibiotics and psycho-active drugs, still remains difficult to evaluate. Using an in vivo picosecond optical spectroscopy imaging method, we report that chloramphenicol (CAP), besides its well-known ability to inhibit the mitochondria protein synthesis, also influences the NADH/NAD+ redox processes of the respiratory chain. At a 200-mg/kg dose, CAP indeed produces a marked increase in the fluorescent signal of the nRD which, according to clear evidence, is likely to be related to the NADH concentration. This effect also implies an efficient inhibition of complex I of the respiratory chain by CAP. It refers to the mechanism through which the adverse effects of the antibiotic may take place. It could explain why paradoxical sleep, a state needing aerobic energy to occur, is suppressed after CAP administration. The present approach constitutes the first attempt to determine by fluorescence methods the effects of substances on deep brain structures of the freely moving animal. It points out that in vivo ultrafast optical methods are innovative and adequate tools for combined neurochemical and behavioural approaches.

New uses of older antibiotics

Despite the development of extended-spectrum penicillins, cephalosporins, and quinolones, the older antimicrobial agents, doxycycline, minocycline, TMP-SMX, clindamycin, and metronidazole, still play an important role in the treatment of infectious diseases. All of these older drugs are well absorbed by the oral route, attaining serum levels equivalent to those achieved by parenteral administration. The availability of generic forms of the older drugs reduces their cost. Besides traditional uses, some older drugs have become the preferred therapy for newly recognized infectious diseases. Doxycycline is the preferred drug for rickettsial tickborne diseases, ehrlichiosis and early Lyme disease. TMP-SMX is the preferred drug for I. belli and Cyclospora. Minocycline has been used to treat MRSA and MRSE infections. Clindamycin or metronidazole combined with a quinolone is an excellent oral regimen for polymicrobial infections. [table: see text]

Clindamycin, metronidazole, and chloramphenicol

Clindamycin, metronidazole, and chloramphenicol are three antimicrobial agents useful in the treatment of anaerobic infections. Clindamycin is effective in the treatment of most infections involving anaerobes and gram-positive cocci, but emerging resistance has become a problem in some clinical settings. Metronidazole is effective in the treatment of infections involving gram-negative anaerobes, but it is unreliable in the treatment of gram-positive anaerobic infections and is ineffective in treating aerobic infections. Additionally, metronidazole is often the drug of choice in treating infections in which Bacteroides fragilis is a serious concern. Chloramphenicol is effective in the treatment of a wide variety of bacterial infections, including serious anaerobic infections, but is rarely used in Western countries because of concerns about toxicity, including aplastic anemia and gray baby syndrome.

Laboratory guidelines for monitoring of antimicrobial drugs

Few antimicrobial drugs meet the requirements for therapeutic drug monitoring. Those that are monitored include the aminoglycosides (gentamicin, tobramycin, and amikacin), chloramphenicol, and in some cases, vancomycin. For these drugs, there is evidence of a relationship between serum concentration, efficacy, and/or the incidence of adverse or toxic events. Monitoring begins with the appropriate timing of collection and continues through the analytical process to the integration of all data used to guide the clinician’s next decision.

Identification of major biliary and urinary metabolites of ecabapide in rats

1. The structures of major biliary and urinary metabolites of ecabapide in rat were identified by comparison with authentic standards using lc-ms and 1H-nmr spectrometry. 2. A major metabolite was found in the bile obtained from rat after an oral dose of 14C-ecabapide and identified as the amidaldehyde derivative. In the urine, two polar metabolites were characterized as the phenolic sulphates. Further, two lipophilic metabolites were identified as alcohol derivatives, and two others as oxamic acids. 3. From these results, it was estimated that the first step in the metabolism of ecabapide in rat was oxidative N-dealkylation to produce the amidaldehyde. This amidaldehyde was further metabolized by two routes, one by reduction of the amidaldehyde into the corresponding alcohol followed by mono-demethylation and subsequent aromatic O-sulphation, the second by oxidation of the amidaldehyde into the oxamic acid followed by mono-demethylation and subsequent aromatic O-sulphation.