----- Original Message -----
From: William Farler <[log in to unmask]>
Date: Wednesday, April 21, 2004 10:13 am
Subject: [BEE-L] China
  After fuel, trucks, syrup and wood
> about all that's left is labor and chemicals.  The Chinese
> apparently feel they can save on chemicals by using REALLY strong
> stuff.  Chloramphenical is a last resort, high power chemical.

Chloramphenicol, while being held in reserve for particular infections and circumstances, is not particularly "strong."  In fact, the term strong is hard to apply to antibiotics as the one antibiotic might be considered a big gun in some instances, and completely ineffective in others.  The question is “does it kill a particular bacterium at levels that the host can tolerate?” not “is it strong.”

One should not take the idea that because it is used only in particular circumstances, and therefore "special" to mean that it is inherently expensive.  The stuff has been around a long time and may be simply being made in huge quantities over there and therefore inexpensive.  Chlormaphenicols’ main attractant is that it gets into all kinds of tissues very effectively.  One of the main detractors is that nasty aplastic anemia thing.  So, it is reserved for susceptible infections in weird places that are poorly treated with other things – not because it is particularly “strong."  In fact it was once a common drug used for upper respiratory tract infections in kids.  Now there are better, safer choices.

Honestly, given the possible scenarios people are listing as to why one might choose this drug, and there would be better choices out there - they might be more expensive.  Depends on what the local pharmaceutical industry over there is set up to do.  They may make it by the tanker load.  Personally I suspect it is simply cheap and available in that setting.  So, it gets used.

Keith

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