National audit of prescribing of warfarin or 300mg aspirin a day, as reported in the News section of the May issue of Guidelines in Practice, should provide useful and illuminating data, and the results are awaited with interest.
It will be useful to relate this to information that was anticipated in ABC of Atrial Fibrillation, edited by Dr Gregory YH Lip.
First published in 1996, this revealed that large-scale randomised studies exploring the use of very low intensity warfarin and aspirin, and combinations of these, were in progress. It is reasonable to think that the results of these trials should now be available.
In my experience, warfarin and 75mg aspirin in combination prevented transient ischaemic attacks better than either agent alone.
Dr ER Blay, retired GP, Fareham
I found the section 'Practice Initiatives' (May) easy to relate to and practical – unlike evidence from large trials.
Dr HM Dalal, GP, Truro
I am currently researching implementation of guidelines for the management of recurrent vaginal infections for use by nurses.
I would be interested to know of the existence of any guidelines in this area. Can any readers help with my search?
Dr DJ Pilling, GP, Cleveleys, Lancashire