BMJ 1995;311:450 (12 August)

Letters

Is it time to stop using chloramphenicol on the eye?

Fears are based on only six cases

EDITOR,--Marie Doona and J Bernard Walsh highlight the association between topical ophthalmic use of chloramphenicol and bone marrow aplasia.1 Although we accept that the risk of aplasia developing after systemic use of chloramphenicol is 13 times higher than that in the general population, we believe there is little evidence to implicate topical chloramphenicol as a cause of aplastic anaemia. We have reviewed the literature and were surprised that the "numerous" articles referred to by the authors amount to six published case reports.

Several important features of these cases come to light on close scrutiny. The most alarming feature is the period for which topical chloramphenicol was used, ranging from 40 days to five years.2 3 4 This to us suggests injudicious prescribing practice. At least two of the patients had other possible explanations for aplasia. One received topical chloramphenicol plus sulphonamide (sulfacetamide).2 Another had abnormal . . . [Full text of this article]


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Relevant Article

Use of chloramphenicol as topical eye medication: time to cry halt?
Marie Doona and J Bernard Walsh
BMJ 1995 310: 1217-1218. [Extract] [Full Text]

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