Gray baby syndrome

Not to be confused with Bronze baby syndrome.
Gray baby syndrome
Other namesGrey baby syndrome, gray syndrome, grey syndrome
SpecialtyPediatrics, infectious disease, toxicology
SymptomsVomiting, greenish diarrhea, abdominal distension, hypothermia, pallid cyanosis, irregular respiration, circulatory collapse
ComplicationsBleeding, hepatic failure, anemia, kernicterus, death
Usual onsetNeonates
CausesAccumulation of chloramphenicol
Diagnostic methodproper history taking, monitoring blood level of the drug

Gray baby syndrome (also termed gray syndrome or grey syndrome) is a rare but serious, even fatal, side effect that occurs in newborn infants (especially premature babies) following the accumulation of the antibiotic chloramphenicol.[1] Chloramphenicol is a broad-spectrum antibiotic that has been used to treat a variety of bacteria infections like Streptococcus pneumoniae as well as typhoid fever, meningococcal sepsis, cholera, and eye infections.[2][3] Chloramphenicol works by binding to ribosomal subunits which blocks transfer ribonucleic acid (RNA) and prevents the synthesis of bacterial proteins.[4][5] Chloramphenicol has also been used to treat neonates born before 37 weeks of the gestational period for prophylactic purposes.[2][6][4] In 1958, newborns born prematurely due to rupture of the amniotic sac were given chloramphenicol to prevent possible infections, and it was noticed that these newborns had a higher mortality rate compared with those who were not treated with the antibiotic.[7] Over the years, chloramphenicol has been used less in clinical practice due to the risks of toxicity not only to neonates, but also to adults due to the risk of aplastic anemia.[3][8][9] Chloramphenicol is now reserved to treat certain severe bacteria infections that were not successfully treated with other antibiotic medications.

  1. ^ McIntyre J, Choonara I (2004). "Drug toxicity in the neonate". Biology of the Neonate. 86 (4): 218–21. doi:10.1159/000079656. PMID 15249753. S2CID 29906856.
  2. ^ a b Deveci A, Coban AY (September 2014). "Optimum management of Citrobacter koseri infection". Expert Review of Anti-Infective Therapy. 12 (9): 1137–42. doi:10.1586/14787210.2014.944505. PMID 25088467. S2CID 37304019.
  3. ^ a b "Chloramphenicol", LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases, 2012, PMID 31643435, retrieved 2021-08-02
  4. ^ a b Cite error: The named reference Oong_2012 was invoked but never defined (see the help page).
  5. ^ Vázquez-Laslop N, Mankin AS (September 2018). "Context-Specific Action of Ribosomal Antibiotics". Annual Review of Microbiology. 72 (1): 185–207. doi:10.1146/annurev-micro-090817-062329. PMC 8742604. PMID 29906204.
  6. ^ Cummings ED, Kong EL, Edens MA (2021). "Gray Baby Syndrome". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 28846297. Retrieved 2021-07-30.
  7. ^ Powell DA, Nahata MC (April 1982). "Chloramphenicol: new perspectives on an old drug". Drug Intelligence & Clinical Pharmacy. 16 (4): 295–300. doi:10.1177/106002808201600404. PMID 7040026. S2CID 103247.
  8. ^ Ingebrigtsen SG, Didriksen A, Johannessen M, Škalko-Basnet N, Holsæter AM (June 2017). "Old drug, new wrapping – A possible comeback for chloramphenicol?". International Journal of Pharmaceutics. 526 (1–2): 538–546. doi:10.1016/j.ijpharm.2017.05.025. hdl:10037/12466. PMID 28506801.
  9. ^ Beninger P (December 2018). "Pharmacovigilance: An Overview". Clinical Therapeutics. 40 (12): 1991–2004. doi:10.1016/j.clinthera.2018.07.012. PMID 30126707.