Which antibiotic is historically associated with fatal aplastic anemia?

• A. Nephrotoxicity
• B. Pulmonary fibrosis
• C. Chloramphenicol
• D. Hepatotoxicity

Answer: (C)

Chloramphenicol carries a unique, historically important risk: it can cause fatal aplastic anemia, a serious suppression of bone marrow that leads to pancytopenia. This reaction is idiosyncratic and not reliably dose-related, so it can occur unpredictably after weeks of therapy and may be fatal even at standard doses. Because of this danger, its use is restricted to serious infections when safer alternatives aren’t available. The other listed toxicities—nephrotoxicity, pulmonary fibrosis, and hepatotoxicity—are associated with different drugs, but they don’t define the classic risk tied to this antibiotic.