Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical medicine. Current estimates suggest that 4-5 million individuals in the United States

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Widespread use of topical chloramphenicol EDIroR,-The recent debate over the safety of topical chloramphenicol has caused a widespread response in the ophthalmic literature. The article by McGhee and Anastas' has reviewed the current knowledge and concluded that there is a theoretical but not conclusively proved risk of aplastic anaemia in the use of topical ophthalmic chloramphenicol. I wish to add a comment which was not discussed in this paper. The authors quoted an idiopathic aplastic anaemia incidence of 1 in 524 000, or 2 per million in the USA. The use of chloramphenicol in Europe is 40 times the amount of that in the USA and reflects the different prescribing habits between the two communities. If topical ocular chloramphenicol was to have a relation to aplastic anaemia the incidence in Europe will be expected to be higher than in the USA. This issue was addressed by Gardner' who quoted an incidence of 1.5 per million cases of aplastic anaemia in France, a similar figure to that of the USA. These data suggest that there is no difference in the incidence of aplastic anaemia when topical ocular chloramphenicol is prescribed compared with when it is not. Practitioners should continue to use this effective drug until there is firm evidence that it is not safe.