| Record Information |
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| Version | 5.0 |
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| Status | Expected but not Quantified |
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| Creation Date | 2012-09-06 15:16:49 UTC |
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| Update Date | 2022-03-07 02:51:40 UTC |
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| HMDB ID | HMDB0014589 |
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| Secondary Accession Numbers | |
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| Metabolite Identification |
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| Common Name | Chloramphenicol |
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| Description | Chloramphenicol, also known as chloromycetin or chloramex, belongs to the class of organic compounds known as nitrobenzenes. Nitrobenzenes are compounds containing a nitrobenzene moiety, which consists of a benzene ring with a carbon bearing a nitro group. Chloramphenicol is a drug which is used in treatment of cholera, as it destroys the vibrios and decreases the diarrhea. it is effective against tetracycline-resistant vibrios. it is also used in eye drops or ointment to treat bacterial conjunctivitis. Drug therapy is discontinued immediately; exchange transfusion may be required to remove the drug. Chloramphenicol is an extremely weak basic (essentially neutral) compound (based on its pKa). Chloramphenicol exists in all living organisms, ranging from bacteria to humans. An antibiotic first isolated from cultures of Streptomyces venequelae in 1947 but now produced synthetically. In humans, chloramphenicol is involved in chloramphenicol action pathway. Chloramphenicol is formally rated as a probable carcinogen (by IARC 2A) and is also a potentially toxic compound. Chloramphenicol targets the large 39S subunit of the mitochondrial ribosome thereby deactivation mitochondrial protein synthesis. It acts by interfering with bacterial protein synthesis and is mainly bacteriostatic. |
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| Structure | OC[C@@H](NC(=O)C(Cl)Cl)[C@H](O)C1=CC=C(C=C1)[N+]([O-])=O InChI=1S/C11H12Cl2N2O5/c12-10(13)11(18)14-8(5-16)9(17)6-1-3-7(4-2-6)15(19)20/h1-4,8-10,16-17H,5H2,(H,14,18)/t8-,9-/m1/s1 |
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| Synonyms | | Value | Source |
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| Chloramex | ChEBI | | Chloramphenicolum | ChEBI | | Chlornitromycin | ChEBI | | Chlorocid | ChEBI | | Chlorocol | ChEBI | | Chloromycetin | ChEBI | | Cloramfenicol | ChEBI | | D-(-)-2,2-Dichloro-N-(beta-hydroxy-alpha-(hydroxymethyl)-p-nitrophenylethyl)acetamide | ChEBI | | D-(-)-Threo-1-p-nitrophenyl-2-dichloroacetylamino-1,3-propanediol | ChEBI | | Fenicol | ChEBI | | Globenicol | ChEBI | | Halomycetin | ChEBI | | Laevomycetinum | ChEBI | | Levomicetina | ChEBI | | Levomycetin | ChEBI | | Oleomycetin | ChEBI | | Sificetina | ChEBI | | CP | Kegg | | Amphicol | Kegg | | Econochlor | Kegg | | D-(-)-2,2-Dichloro-N-(b-hydroxy-a-(hydroxymethyl)-p-nitrophenylethyl)acetamide | Generator | | D-(-)-2,2-Dichloro-N-(β-hydroxy-α-(hydroxymethyl)-p-nitrophenylethyl)acetamide | Generator | | CAF | HMDB | | CAP | HMDB | | Chloramfenikol | HMDB | | Chloramphenicole | HMDB | | Chloroamphenicol | HMDB | | Cloroamfenicolo | HMDB | | D-Chloramphenicol | HMDB | | Detreomycin | HMDB | | Kloramfenikol | HMDB | | Cloranfenicol | HMDB | | Ophthochlor | HMDB | | Syntomycin | HMDB | | Amphenicols | MeSH | | Amphenicol | MeSH |
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| Chemical Formula | C11H12Cl2N2O5 |
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| Average Molecular Weight | 323.129 |
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| Monoisotopic Molecular Weight | 322.012326918 |
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| IUPAC Name | 2,2-dichloro-N-[(1R,2R)-1,3-dihydroxy-1-(4-nitrophenyl)propan-2-yl]acetamide |
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| Traditional Name | chloramphenicol |
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| CAS Registry Number | 56-75-7 |
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| SMILES | OC[C@@H](NC(=O)C(Cl)Cl)[C@H](O)C1=CC=C(C=C1)[N+]([O-])=O |
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| InChI Identifier | InChI=1S/C11H12Cl2N2O5/c12-10(13)11(18)14-8(5-16)9(17)6-1-3-7(4-2-6)15(19)20/h1-4,8-10,16-17H,5H2,(H,14,18)/t8-,9-/m1/s1 |
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| InChI Key | WIIZWVCIJKGZOK-RKDXNWHRSA-N |
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| Chemical Taxonomy |
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| Description | Belongs to the class of organic compounds known as nitrobenzenes. Nitrobenzenes are compounds containing a nitrobenzene moiety, which consists of a benzene ring with a carbon bearing a nitro group. |
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| Kingdom | Organic compounds |
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| Super Class | Benzenoids |
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| Class | Benzene and substituted derivatives |
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| Sub Class | Nitrobenzenes |
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| Direct Parent | Nitrobenzenes |
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| Alternative Parents | |
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| Substituents | - Nitrobenzene
- Nitroaromatic compound
- C-nitro compound
- Secondary alcohol
- Organic nitro compound
- Carboximidic acid
- Carboximidic acid derivative
- Organic oxoazanium
- Allyl-type 1,3-dipolar organic compound
- Propargyl-type 1,3-dipolar organic compound
- Organic 1,3-dipolar compound
- Aromatic alcohol
- Organopnictogen compound
- Primary alcohol
- Organooxygen compound
- Organonitrogen compound
- Organochloride
- Alkyl halide
- Organohalogen compound
- Organic oxygen compound
- Organic nitrogen compound
- Organic zwitterion
- Alcohol
- Alkyl chloride
- Organic oxide
- Hydrocarbon derivative
- Aromatic homomonocyclic compound
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| Molecular Framework | Aromatic homomonocyclic compounds |
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| External Descriptors | |
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| Ontology |
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| Physiological effect | Not Available |
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| Disposition | |
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| Process | |
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| Role | |
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| Physical Properties |
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| State | Solid |
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| Experimental Molecular Properties | | Property | Value | Reference |
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| Melting Point | 150.5 °C | Not Available | | Boiling Point | Not Available | Not Available | | Water Solubility | 0.46 g/L | Not Available | | LogP | 0.7 | Not Available |
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| Experimental Chromatographic Properties | Not Available |
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| Predicted Molecular Properties | |
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| Predicted Chromatographic Properties | Predicted Collision Cross SectionsPredicted Retention Times Underivatized| Chromatographic Method | Retention Time | Reference |
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| Measured using a Waters Acquity ultraperformance liquid chromatography (UPLC) ethylene-bridged hybrid (BEH) C18 column (100 mm × 2.1 mm; 1.7 μmparticle diameter). Predicted by Afia on May 17, 2022. Predicted by Afia on May 17, 2022. | 3.91 minutes | 32390414 | | Predicted by Siyang on May 30, 2022 | 11.2426 minutes | 33406817 | | Predicted by Siyang using ReTip algorithm on June 8, 2022 | 2.4 minutes | 32390414 | | AjsUoB = Accucore 150 Amide HILIC with 10mM Ammonium Formate, 0.1% Formic Acid | 36.2 seconds | 40023050 | | Fem_Long = Waters ACQUITY UPLC HSS T3 C18 with Water:MeOH and 0.1% Formic Acid | 1465.2 seconds | 40023050 | | Fem_Lipids = Ascentis Express C18 with (60:40 water:ACN):(90:10 IPA:ACN) and 10mM NH4COOH + 0.1% Formic Acid | 284.5 seconds | 40023050 | | Life_Old = Waters ACQUITY UPLC BEH C18 with Water:(20:80 acetone:ACN) and 0.1% Formic Acid | 117.7 seconds | 40023050 | | Life_New = RP Waters ACQUITY UPLC HSS T3 C18 with Water:(30:70 MeOH:ACN) and 0.1% Formic Acid | 180.2 seconds | 40023050 | | RIKEN = Waters ACQUITY UPLC BEH C18 with Water:ACN and 0.1% Formic Acid | 59.3 seconds | 40023050 | | Eawag_XBridgeC18 = XBridge C18 3.5u 2.1x50 mm with Water:MeOH and 0.1% Formic Acid | 313.6 seconds | 40023050 | | BfG_NTS_RP1 =Agilent Zorbax Eclipse Plus C18 (2.1 mm x 150 mm, 3.5 um) with Water:ACN and 0.1% Formic Acid | 378.1 seconds | 40023050 | | HILIC_BDD_2 = Merck SeQuant ZIC-HILIC with ACN(0.1% formic acid):water(16 mM ammonium formate) | 134.0 seconds | 40023050 | | UniToyama_Atlantis = RP Waters Atlantis T3 (2.1 x 150 mm, 5 um) with ACN:Water and 0.1% Formic Acid | 828.3 seconds | 40023050 | | BDD_C18 = Hypersil Gold 1.9µm C18 with Water:ACN and 0.1% Formic Acid | 330.0 seconds | 40023050 | | UFZ_Phenomenex = Kinetex Core-Shell C18 2.6 um, 3.0 x 100 mm, Phenomenex with Water:MeOH and 0.1% Formic Acid | 1081.8 seconds | 40023050 | | SNU_RIKEN_POS = Waters ACQUITY UPLC BEH C18 with Water:ACN and 0.1% Formic Acid | 272.7 seconds | 40023050 | | RPMMFDA = Waters ACQUITY UPLC BEH C18 with Water:ACN and 0.1% Formic Acid | 291.8 seconds | 40023050 | | MTBLS87 = Merck SeQuant ZIC-pHILIC column with ACN:Water and :ammonium carbonate | 390.5 seconds | 40023050 | | KI_GIAR_zic_HILIC_pH2_7 = Merck SeQuant ZIC-HILIC with ACN:Water and 0.1% FA | 288.1 seconds | 40023050 | | Meister zic-pHILIC pH9.3 = Merck SeQuant ZIC-pHILIC column with ACN:Water 5mM NH4Ac pH9.3 and 5mM ammonium acetate in water | 123.2 seconds | 40023050 |
Predicted Kovats Retention IndicesUnderivatizedDerivatized| Derivative Name / Structure | SMILES | Kovats RI Value | Column Type | Reference |
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| Chloramphenicol,1TMS,isomer #1 | C[Si](C)(C)OC[C@@H](NC(=O)C(Cl)Cl)[C@H](O)C1=CC=C([N+](=O)[O-])C=C1 | 2458.2 | Semi standard non polar | 33892256 | | Chloramphenicol,1TMS,isomer #2 | C[Si](C)(C)O[C@H](C1=CC=C([N+](=O)[O-])C=C1)[C@@H](CO)NC(=O)C(Cl)Cl | 2442.1 | Semi standard non polar | 33892256 | | Chloramphenicol,1TMS,isomer #3 | C[Si](C)(C)N(C(=O)C(Cl)Cl)[C@H](CO)[C@H](O)C1=CC=C([N+](=O)[O-])C=C1 | 2480.0 | Semi standard non polar | 33892256 | | Chloramphenicol,2TMS,isomer #1 | C[Si](C)(C)OC[C@@H](NC(=O)C(Cl)Cl)[C@H](O[Si](C)(C)C)C1=CC=C([N+](=O)[O-])C=C1 | 2429.8 | Semi standard non polar | 33892256 | | Chloramphenicol,2TMS,isomer #2 | C[Si](C)(C)OC[C@H]([C@H](O)C1=CC=C([N+](=O)[O-])C=C1)N(C(=O)C(Cl)Cl)[Si](C)(C)C | 2465.8 | Semi standard non polar | 33892256 | | Chloramphenicol,2TMS,isomer #3 | C[Si](C)(C)O[C@H](C1=CC=C([N+](=O)[O-])C=C1)[C@@H](CO)N(C(=O)C(Cl)Cl)[Si](C)(C)C | 2500.3 | Semi standard non polar | 33892256 | | Chloramphenicol,3TMS,isomer #1 | C[Si](C)(C)OC[C@H]([C@H](O[Si](C)(C)C)C1=CC=C([N+](=O)[O-])C=C1)N(C(=O)C(Cl)Cl)[Si](C)(C)C | 2528.1 | Semi standard non polar | 33892256 | | Chloramphenicol,3TMS,isomer #1 | C[Si](C)(C)OC[C@H]([C@H](O[Si](C)(C)C)C1=CC=C([N+](=O)[O-])C=C1)N(C(=O)C(Cl)Cl)[Si](C)(C)C | 2503.2 | Standard non polar | 33892256 | | Chloramphenicol,3TMS,isomer #1 | C[Si](C)(C)OC[C@H]([C@H](O[Si](C)(C)C)C1=CC=C([N+](=O)[O-])C=C1)N(C(=O)C(Cl)Cl)[Si](C)(C)C | 2922.8 | Standard polar | 33892256 | | Chloramphenicol,1TBDMS,isomer #1 | CC(C)(C)[Si](C)(C)OC[C@@H](NC(=O)C(Cl)Cl)[C@H](O)C1=CC=C([N+](=O)[O-])C=C1 | 2734.8 | Semi standard non polar | 33892256 | | Chloramphenicol,1TBDMS,isomer #2 | CC(C)(C)[Si](C)(C)O[C@H](C1=CC=C([N+](=O)[O-])C=C1)[C@@H](CO)NC(=O)C(Cl)Cl | 2724.8 | Semi standard non polar | 33892256 | | Chloramphenicol,1TBDMS,isomer #3 | CC(C)(C)[Si](C)(C)N(C(=O)C(Cl)Cl)[C@H](CO)[C@H](O)C1=CC=C([N+](=O)[O-])C=C1 | 2804.7 | Semi standard non polar | 33892256 | | Chloramphenicol,2TBDMS,isomer #1 | CC(C)(C)[Si](C)(C)OC[C@@H](NC(=O)C(Cl)Cl)[C@H](O[Si](C)(C)C(C)(C)C)C1=CC=C([N+](=O)[O-])C=C1 | 2983.6 | Semi standard non polar | 33892256 | | Chloramphenicol,2TBDMS,isomer #2 | CC(C)(C)[Si](C)(C)OC[C@H]([C@H](O)C1=CC=C([N+](=O)[O-])C=C1)N(C(=O)C(Cl)Cl)[Si](C)(C)C(C)(C)C | 3040.7 | Semi standard non polar | 33892256 | | Chloramphenicol,2TBDMS,isomer #3 | CC(C)(C)[Si](C)(C)O[C@H](C1=CC=C([N+](=O)[O-])C=C1)[C@@H](CO)N(C(=O)C(Cl)Cl)[Si](C)(C)C(C)(C)C | 3056.9 | Semi standard non polar | 33892256 | | Chloramphenicol,3TBDMS,isomer #1 | CC(C)(C)[Si](C)(C)OC[C@H]([C@H](O[Si](C)(C)C(C)(C)C)C1=CC=C([N+](=O)[O-])C=C1)N(C(=O)C(Cl)Cl)[Si](C)(C)C(C)(C)C | 3288.7 | Semi standard non polar | 33892256 | | Chloramphenicol,3TBDMS,isomer #1 | CC(C)(C)[Si](C)(C)OC[C@H]([C@H](O[Si](C)(C)C(C)(C)C)C1=CC=C([N+](=O)[O-])C=C1)N(C(=O)C(Cl)Cl)[Si](C)(C)C(C)(C)C | 3139.3 | Standard non polar | 33892256 | | Chloramphenicol,3TBDMS,isomer #1 | CC(C)(C)[Si](C)(C)OC[C@H]([C@H](O[Si](C)(C)C(C)(C)C)C1=CC=C([N+](=O)[O-])C=C1)N(C(=O)C(Cl)Cl)[Si](C)(C)C(C)(C)C | 3136.8 | Standard polar | 33892256 |
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| GC-MS Spectra| Spectrum Type | Description | Splash Key | Deposition Date | Source | View |
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| Predicted GC-MS | Predicted GC-MS Spectrum - Chloramphenicol GC-MS (Non-derivatized) - 70eV, Positive | splash10-0udi-3900000000-2ba6754ba027027454d1 | 2017-09-01 | Wishart Lab | View Spectrum | | Predicted GC-MS | Predicted GC-MS Spectrum - Chloramphenicol GC-MS (2 TMS) - 70eV, Positive | splash10-0udi-3911100000-5438beab478c45792ddb | 2017-10-06 | Wishart Lab | View Spectrum | | Predicted GC-MS | Predicted GC-MS Spectrum - Chloramphenicol GC-MS (Non-derivatized) - 70eV, Positive | Not Available | 2021-10-12 | Wishart Lab | View Spectrum | | Predicted GC-MS | Predicted GC-MS Spectrum - Chloramphenicol GC-MS (Non-derivatized) - 70eV, Positive | Not Available | 2021-10-12 | Wishart Lab | View Spectrum |
MS/MS Spectra| Spectrum Type | Description | Splash Key | Deposition Date | Source | View |
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| Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-qTof , Positive-QTOF | splash10-014i-0920000000-96bfb1c31d89e3f10caf | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , negative-QTOF | splash10-0kmi-0945000000-40a09f3f9528bd669823 | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , negative-QTOF | splash10-0udi-0900000000-64dbb16119292f4410e2 | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , negative-QTOF | splash10-0udi-0900000000-5c8fbcad8e93fa9f2906 | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , negative-QTOF | splash10-0uk9-1900000000-4c6518583a7488591aa3 | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , negative-QTOF | splash10-00di-1900000000-00574ed667d64b4a45e9 | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , negative-QTOF | splash10-00di-1900000000-d4ac63e9260ab31ac6b1 | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QTOF , negative-QTOF | splash10-0zml-0933000000-4ae209b29cb52d4e3844 | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QTOF , negative-QTOF | splash10-056r-0933000000-74ff5ec451e56526d425 | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol Linear Ion Trap , negative-QTOF | splash10-0a4l-0590000000-90d108018a0f99815fb7 | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol Linear Ion Trap , negative-QTOF | splash10-0a4l-0690000000-161f2afa43298fd3437a | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , negative-QTOF | splash10-0uk9-0923000000-86308db0ec59b40b1533 | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , positive-QTOF | splash10-05fr-0094000000-ad8da59124745b38a76f | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , positive-QTOF | splash10-00di-0390000000-06fcf307f2fdb79741ad | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , positive-QTOF | splash10-014i-1940000000-be07d702045f4d3e05ac | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , positive-QTOF | splash10-014i-1910000000-55a74a828c3c9750ee1c | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , positive-QTOF | splash10-0159-2900000000-bf685c17ab79583133ee | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QFT , positive-QTOF | splash10-0159-4900000000-e6f6ccbfffe89c345365 | 2017-09-14 | HMDB team, MONA | View Spectrum | | Experimental LC-MS/MS | LC-MS/MS Spectrum - Chloramphenicol LC-ESI-QTOF , positive-QTOF | splash10-00di-0191000000-41f70006e2b4e5f8d8aa | 2017-09-14 | HMDB team, MONA | View Spectrum | | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - Chloramphenicol 10V, Positive-QTOF | splash10-00di-0109000000-7f19e2214bd804fbb572 | 2016-08-03 | Wishart Lab | View Spectrum | | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - Chloramphenicol 20V, Positive-QTOF | splash10-014j-0289000000-ea9835706b530fa07197 | 2016-08-03 | Wishart Lab | View Spectrum | | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - Chloramphenicol 40V, Positive-QTOF | splash10-03di-2910000000-531d8b69053d0c007aeb | 2016-08-03 | Wishart Lab | View Spectrum | | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - Chloramphenicol 10V, Negative-QTOF | splash10-00di-0109000000-cc647af0a1726c8e11c5 | 2016-08-03 | Wishart Lab | View Spectrum | | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - Chloramphenicol 20V, Negative-QTOF | splash10-0229-3915000000-a08bc180ba95289b9297 | 2016-08-03 | Wishart Lab | View Spectrum | | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - Chloramphenicol 40V, Negative-QTOF | splash10-004i-4900000000-7ccaa4da01cb96a52d23 | 2016-08-03 | Wishart Lab | View Spectrum |
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| General References | - Wali SS, Macfarlane JT, Weir WR, Cleland PG, Ball PA, Hassan-King M, Whittle HC, Greenwood BM: Single injection treatment of meningococcal meningitis. 2. Long-acting chloramphenicol. Trans R Soc Trop Med Hyg. 1979;73(6):698-702. [PubMed:538813 ]
- Bhutta ZA, Niazi SK, Suria A: Chloramphenicol clearance in typhoid fever: implications for therapy. Indian J Pediatr. 1992 Mar-Apr;59(2):213-9. [PubMed:1398851 ]
- Pecoul B, Varaine F, Keita M, Soga G, Djibo A, Soula G, Abdou A, Etienne J, Rey M: Long-acting chloramphenicol versus intravenous ampicillin for treatment of bacterial meningitis. Lancet. 1991 Oct 5;338(8771):862-6. [PubMed:1681224 ]
- Puddicombe JB, Wali SS, Greenwood BM: A field trial of a single intramuscular injection of long-acting chloramphenicol in the treatment of meningococcal meningitis. Trans R Soc Trop Med Hyg. 1984;78(3):399-403. [PubMed:6464136 ]
- Nathan N, Borel T, Djibo A, Evans D, Djibo S, Corty JF, Guillerm M, Alberti KP, Pinoges L, Guerin PJ, Legros D: Ceftriaxone as effective as long-acting chloramphenicol in short-course treatment of meningococcal meningitis during epidemics: a randomised non-inferiority study. Lancet. 2005 Jul 23-29;366(9482):308-13. [PubMed:16039333 ]
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