International Board of Certified Lactation Consultant (IBCLC) Practice Exam

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Which medication can be extremely toxic to neonates and should not be used for trivial infections?

Gentamicin
Ampicillin
Chloramphenicol
Metronidazole

The correct answer is: Chloramphenicol

Chloramphenicol is known to be extremely toxic to neonates primarily due to its association with the potentially life-threatening condition known as "gray baby syndrome." This condition can occur because neonates have immature liver enzymes that are unable to adequately metabolize chloramphenicol. When administered, the drug can reach toxic levels, leading to cardiovascular collapse, hypotension, and metabolic acidosis. The risk of toxicity is particularly significant for trivial infections, where the use of such a powerful antibiotic is not justified. Due to its severe side effects and high potential for toxicity in this vulnerable population, chloramphenicol is generally avoided in neonates unless absolutely necessary and no alternatives are available. This is in contrast to the other medications listed, which are typically considered safe and effective for use in neonates when necessary.