Chloramphenicol and chloramphenicol succinate concentrations in patients with renal impairment

The renal excretion of SCAP can be impaired in patients with renal insufficiency resulting in increased SCAP concentrations. These increased SCAP concentrations may increase the amount of SCAP converted to CAP resulting in increased CAP concentrations. In the two patients we studied with creatinine clearances of less than 20 ml/min, but without serious liver disease, serum CAP concentrations were not elevated. However, until more information is available, we recommend that CAP serum concentrations be determined for patients with renal insufficiency and that these patients are monitored closely for hematologic toxicity.