Chloramphenicol represents the drug of choice for severe infections due to salmonellae1 and is regarded as the alternative agent of choice for patients sensitive to penicillin who develop pneumococcal, meningococcal, or Haemophilus influenzae meningitis.2 With the increasing number of reports of strains of H influenzae recovered from the cerebrospinal fluid that are resistant to ampicillin, chloramphenicol will play an even greater role in the therapy of bacterial meningitis.3,4
Recent extensive reports have unequivocally established the important role of anaerobes, particularly Bacteroides fragilis, as causative agents in a wide range of major infections in man.5-7 Since virtually all anaerobes, except B fragilis, are susceptible to penicillin, and as that agent has a tried and proved record of excellence, recent pharmaceutical industry efforts have been extended to find safe and effective drugs for B fragilis. Some promising agents, such as rifampin, metronidazole, and thiamphenicol, are currently under investigation.