Topical chloramphenicol : have GPs

Sir, An editorial in the British Medical Journal (BMJ)1 on the use of chloramphenicol eye drops suggested that the risks of topical chloramphenicol were sufficient to warrant practitioners to prescribe an alternative, such as Framycetin or Fucidic Acid. We sent a postal questionnaire to 664 general practitioners (GPs) in the areas of Leeds, Guildford, and Cambridge to ascertain the influence this editorial, and ensuing correspondence, had on their prescribing habits eight months later. Three hundred GPs replied, of whom 235 (78.3%) had read the editorial. As a result, 62 (21.7%) of the respondents had initially stopped prescribing topical chloramphenicol. Twenty-one (7%) ultimately reverted to using chloramphenicol, 19 of whom indicated they had read the correspondence in the BMJ that supported the continuing use of topical chloramphenicol. At the time of the questionnaire however, 43 GPs (14.7%) had not reverted to using topical chloramphenicol, despite 13 admitting that they read the articles in support of it. Those GPs who had read the article but did not change their antibiotic practice totalled 164 (54.7%). Fifty-eight had not read the editorial. A further study examining why GPs change their prescribing habits concluded that journal editorials cannot be expected to bring about major change.2 Contrary to this, we found that a significant number of GPs were influenced to change their prescribing habits by the editorial in the BMJ. Although, some degree of bias may occur in a survey such as ours, in that those GPs who had read the editorial and changed their prescribing habits may have been more likely to respond to the questionnaire.