Most common side effect of chloramphenicol drug?

Appeared in: NORCERT 8 Mains-2025

Explanation

Gray baby syndrome is a serious and well-known adverse reaction to chloramphenicol, particularly in premature infants and newborns.
It occurs because neonates have an immature liver enzyme system (deficiency of glucuronyl transferase) and underdeveloped kidney function, leading to an inability to metabolize and excrete the drug.
The accumulation of chloramphenicol to toxic levels interferes with mitochondrial function, causing symptoms like vomiting, abdominal distension, an ashen-gray skin color, and potentially fatal cardiovascular collapse.

Option A: Bronze baby syndrome is not caused by chloramphenicol. It is a rare complication of phototherapy in infants with cholestatic jaundice.
Option C: 'Red baby syndrome' is not a recognized medical term. It is likely intended to be confused with 'Red Man Syndrome'.
Option D: This option is incorrect because Bronze baby syndrome (Option A) is not a side effect of chloramphenicol.

Visual 1: Infographic: A comparative chart showing the key features, causative agents, and clinical presentations of Gray Baby Syndrome, Red Man Syndrome, and Bronze Baby Syndrome.

Clinical Relevance

Nursing practice connection: Knowing Adverse drug reactions of antibiotics, specifically Chloramphenicol helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must be extremely cautious when administering chloramphenicol, especially to neonates. It is a drug with a narrow therapeutic index and significant toxicity, making it a last-resort antibiotic in many settings.
The nurse's role includes monitoring for early signs of toxicity, such as changes in feeding, vomiting, or skin color, and immediately reporting them to the physician.
What if? If an adult patient receives chloramphenicol, the primary and most feared side effect is not Gray baby syndrome but dose-related reversible bone marrow suppression or, more rarely, irreversible and fatal aplastic anemia. The nurse's monitoring would focus on regular blood counts (CBC).

How to Approach the Question

First, identify the core of the question: it asks for a side effect of the drug 'chloramphenicol'.
Next, look at the options. The options are all 'syndromes' related to babies, which strongly hints that the question is focused on a pediatric side effect.
Recall or look up the classic adverse effects of chloramphenicol. The most famous and life-threatening side effect in newborns is Gray baby syndrome.
Evaluate the other options. 'Bronze baby syndrome' is linked to phototherapy, and 'Red baby syndrome' is a distractor for 'Red Man Syndrome' (caused by vancomycin).
Based on this analysis, conclude that Gray baby syndrome is the correct answer.

Concept Tested & Keywords

Concept Tested: Adverse drug reactions of antibiotics, specifically Chloramphenicol.
Stem keywords: chloramphenicol, side effect
Lead-in keywords: Most common
Negative lead-in flag: false

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