BMJ 1995;311:451 (12 August)

Letters

Prospective study of aplastic anaemia should give definitive answer

EDITOR,--We disagree with Marie Doona and J Bernard Walsh's conclusions and recommendations relating to chloramphenicol eye drops and aplastic anaemia.1 Many drugs have been implicated as causing aplastic anaemia, but for most the evidence is weak, and no in vitro tests are available to prove causation. Furthermore, an apparent association may not mean causality: the exposure may have been a response to the early features of aplastic anaemia itself.

An association between use of chloramphenicol and the development of aplastic anaemia was predicted because of the drug's structure, and many reports appeared in the literature during the 1950s and '60s. The risk of developing aplastic anaemia after exposure to oral or intravenous chloramphenicol has been estimated at somewhere between 1 in 25000 and 1 in 800000 exposures, with a figure of about 1 in 60000 being the most acceptable.2 This compares with the overall incidence of aplastic anaemia of two . . . [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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