Pathogenic bacteria under favorable conditions begin active reproduction, causing many diseases. Bacterial infections can affect absolutely any system of the human body or an individual organ, and the eyes are no exception. For the treatment of such diseases eye drops “Chloramphenicol” have been used for decades. In ophthalmic practice, the drug has established itself as effective and relatively safe, and therefore can be prescribed even to children.

The composition of the drug

Eye drops called “Levomycetin” are produced by many manufacturers, and not only in Russia. Therefore, the composition of auxiliary components of various brands may vary. Traditionally, it is boric acid, as well as water for injection, in which the main active ingredient, chloramphenicol, is dissolved. One milliliter of the solution accounts for 2.5 mg of the active substance. However, you can also find less concentrated solutions - with 1.25 mg of chloramphenicol.

In a normal state, an undue preparation is a clear, colorless liquid with a subtle “earthy” odor. Light staining of the solution is allowed.

The product is packaged in glass (transparent or dark glass), polyethylene or polypropylene (transparent and opaque) bottles No. 1 and No. 40 with a volume of 5 or 10 ml.

  • Glass bottles are usually corked with rubber stoppers and rolled in aluminum caps.Can be equipped with a dropper cap.
  • The soft packaging is found with a sealed dropper or with a screw cap for maximum ease of use.

Most often, the bottles are placed in a cardboard box along with the printed instructions.

The drug is dispensed from pharmacies upon presentation of the prescription. Recommended for use for two years from the date of issue. Expired drops are not to be used. The contents of the opened vial retains its therapeutic properties for no longer than 4 weeks.

Drop storage conditions: in a place inaccessible to animals and children, at t <25 ºC. The uncorked bottle is stored at t 15–25 ºC.

Pharmacological action, pharmacodynamics and pharmacokinetics

Chloramphenicol is a synthetic antibiotic that is identical to natural - the vital product of bacteria of the genus streptomycetes. The substance was first isolated from Streptomyces venezuelae culture fluid in the middle of the last century, and later it was obtained by artificial means.

In small doses, the antibiotic exhibits a bacteriostatic effect. With an increase in dose, it is antibacterial. The antimicrobial activity of a substance is determined by its ability to penetrate through the membranes into the cells of pathogenic microorganisms and inhibit protein synthesis in them.

In practice, the effectiveness of Levomycetin against a wide range of bacteria has been proven, including:

  • gram-positive (staphylococcus, streptococcus);
  • gram-negative bacteria (salmonella, klebsiella, shigella, gonococcus, intestinal and hemophilic coli, meningococcus, etc.).

It is noteworthy that chloramphenicol exhibits increased activity against pathogens that are resistant to other popular antibiotics (penicillin, streptomycin, sulfanilamide).

The resistance of the indicated strains to the agent under discussion develops relatively slowly.

After the introduction of Levomycetin eye drops into the conjunctival sac, chloramphenicol is distributed over the cornea of ​​the eye, its iris and vitreous body, reaching a concentration sufficient to provide a therapeutic effect. The antibiotic does not enter the lens, however, it penetrates into the bloodstream in a certain amount.

The half-life of the substance is from one and a half to four hours, but can be extended in patients with liver pathologies, as well as in children under the age of one year. Kidney diseases have almost no effect on the rate of elimination of chloramphenicol, but they can lead to the accumulation of metabolites. About 95% of the substance received is excreted in the urine. Of these, no more than 10% leave the body unchanged, and the rest is processed by the liver. No more than one percent of the metabolites are evacuated by defecation.

What is prescribed eye drops of chloramphenicol

In ophthalmology, chloramphenicol has found application as an effective tool in the fight against bacterial infections.

"Levomycetin" in the form of eye drops is prescribed by doctors for the treatment of diseases provoked by the growth of microflora sensitive to chloramphenicol.

Among them:

  • keratitis;
  • scleritis and episcleritis;
  • blepharitis;
  • conjunctivitis, as well as kerato- and blepharoconjunctivitis.

Instructions for use for adults and children

The medicine is administered drip conjunctival. The dosage for patients of any age is the same: no more than two drops three or four times a day.

  • For children and elderly patients, the dose is not adjusted.
  • Drops for newborns can be prescribed only for health reasons.

The last statement requires a separate decryption. Some manufacturers indicate that the drug can be prescribed without fear to infants older than 4 weeks. Others raise the age limit to several months or even two years. Therefore, in order to avoid the development of negative reactions, it is extremely undesirable to prescribe therapy for your child with eye drops of Levomycetin.

Children's liver is not sufficiently developed to bind chloramphenicol, which can cause its critical accumulation in the body.

This antibiotic is very toxic and can cause "gray syndrome" - a serious condition, often leading to death.

The duration of therapy is five days. If treatment is started at one’s own discretion and does not bring relief within three days, an expert consultation is urgently needed.

During pregnancy and lactation

Animal experiments revealed the teratogenic and embryotoxic effects of chloramphenicol. The substance is able to cross the placental barrier.

The safety of eye drop therapy during gestation is not clinically confirmed, therefore, women in the "Levomycetin" position are strictly contraindicated.

Systemic absorption of the antibiotic in question is not ruled out and its ability to penetrate into breast milk is known for certain, therefore, during lactation, the drug can be used only if the baby is temporarily transferred to artificial feeding.

Drug interaction

Do not combine Levomycetin therapy with the use of pharmaceuticals that inhibit hematopoietic function and metabolic processes in the liver. It is undesirable to resort to treatment with this tool and during the course of radiation therapy in view of the increasing risk of adverse reactions. In addition, chloramphenicol reduces the effectiveness of the antibacterial effects of penicillin and cephalosporin preparations.

If necessary, simultaneous therapy with Levomycetinum with other ophthalmic agents, their administration is spread in time at least half an hour.

Contraindications, side effects and overdose

The drug is prohibited for use in the presence of the following diseases and conditions:

  • individual intolerance to the components of the drug;
  • impaired hematopoiesis;
  • fungal skin lesions, as well as eczema and psoriasis;
  • the entire gestation period;
  • lactation.

The age limit has already been mentioned above. With caution, the therapy with the drug under discussion is carried out in persons who have undergone radiation or a course of treatment with cytostatics.

The use of contact lenses during the entire period of therapy with Levomycetin eye drops is excluded. After treatment, their wearing should be avoided for another day.

Before starting drops therapy with chloramphenicol, you should notify your doctor of a history of:

  • eye injuries;
  • recent conjunctivitis;
  • chronic dry eye syndrome;
  • glaucoma
  • operations on the organs of vision (including laser therapy).

As a rule, treatment with “Levomycetin” eye drops, if the dosage is observed and the absence of predisposing factors, does not cause negative reactions. However, the likelihood of their development can never be ruled out.

Among them, it is extremely rare, but note:

  • temporary irritation of the eye, manifested by itching, burning sensation, redness of the conjunctiva;
  • short-term blurred vision;
  • hypersensitivity reactions;
  • dermatological manifestations of allergies;
  • fever;
  • anaphylactic shock.

Complications of the circulatory system can be observed only with prolonged administration of high (more than 4 grams daily) doses of the drug. Long-term treatment with Levomycetin can provoke toxic reactions, since its active substance is susceptible to systemic absorption from the eyes. So, during therapy with the discussed eye drops, cases of bone marrow hypoplasia were recorded. However, if there is no other way, and long-term treatment with this remedy is required, blood tests should be performed regularly throughout the course.

The likelihood that accidental ingestion of eye drops will cause negative reactions (if we are not talking about small children) is negligible. In the case of the introduction of a large number of drops into the conjunctiva, the occurrence of painful sensations and photophobia, the development of swelling and lacrimation is possible.In such a situation, the eye should be washed with running water at a comfortable temperature. Manipulation is desirable to continue for at least a quarter of an hour.

Due to the high likelihood of temporary blurred vision, after the introduction of the treatment solution, you should not drive and work with precise or dangerous mechanisms.

As already mentioned above, chloramphenicol is highly toxic. And although its concentration in the bloodstream with the introduction of eye drops is small, it is undesirable to resort to the use of “Levomycetin” for uncomplicated banal diseases.

Analogs of Levomycetin in drops

Among the drugs presented in the pharmacy chains of the country, there are no absolute analogues of Levomycetin eye drops. However, the pharmaceutical market offers antibacterial agents based on other active substances.

Among them:

  • "Azidrop". The active substance is azithromycin. The cost is about 350 rubles.
  • Maxitrol. Neomycin, dexamethasone and polymyxin. The cost is about 600 rubles.
  • Tsipromed. Ciprofloxacin. Cost - up to 10 rubles.
  • Phloxal. Ofloxacin. The cost is about 200 rubles.
  • Normax. Norfloxacin. The cost is about 170 rubles.
  • Tobrex. Tobramycin. The cost is about 200 rubles.
  • Oftaquix. Levofloxacin. The cost is about 270 rubles.

But it should be borne in mind that it is impossible to independently replace the “Levomycetin” prescribed by the doctor. Bacterial infections of the eyes are one of the main causes of sudden visual impairment, therefore it is worth approaching the issue of their therapy with all responsibility.

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