الفهرس 
The role of the clinical pharmacy in patient careOnly 14 pages are availabe for public view
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Abstract
Drug-infection interaction should be considered in drug prescribing, as infections downregulate CYP activities and thus may alter drug disposition, especially for narrow therapeutic index drugs. Cyclosporine, still used for the prevention of allograft rejection in renal transplant recipients in Egypt, seems to be affected based on random clinical observations. In the present study, the effects of bacterial and fungal infection on cyclosporine metabolism were studied in renal transplant patients (the Clinical study) and the effects of Candida and e-coli infections separately, and fluconazole administration were tested on cyclosporine metabolism in rabbits (the Animal study). Possible nephrotoxicity was also monitored. Methods. The Clinical study: Twenty renal transplant patients, diagnosed with fungal or bacterial infection, were recruited from the Renal Transplantation Outpatient Clinic in Alexandria University Hospitals. Cyclosporine trough levels and/or serum creatinine concentrations were measured pre-infection, during infection and/or, in many cases, post-infection. No dose adjustment in cyclosporine was performed at least one week before the onset of infection. Exclusion criteria were acute or chronic unstable liver disease, elderly patients and concomitant drugs affecting cyclosporine metabolism.