Drug Interactions With Cyclosporine-Rifampicin-Clarithromycin in a Kidney Transplant Recipient With Mycobacterium Malmoense
Bibliographic record
Abstract
A 38-year-old kidney transplant recipient was treated with antituberculous drugs due to mycobacterial joint infection due to Mycobacterium malmoense. Three days of starting combined therapy, cyclosporine blood concentration (CBC) decreased a 63% and was necessary to increase the cyclosporine dose. Clarithromycin was also added and the CBC and kidney function remained stable until 11 months later. Pirazinamide and isoniazide were withdrawn four months before without any analytical changes but when rifampicin and ethambutol were withdrawn, CBC showed an increase of 377% and creatinine level was worsened. It was necessary to reduce the cyclosporine dose and renal function improved within 6 weeks. When clarithromycin was discontinued, the CBC decreased a 69% which motivated gradually increasing the dose. CBC is liable to change in patients treated with drugs metabolized by cytochrome p450 system, and the effect and magnitude of a multiple interaction is unpredictable. Close monitoring is necessary to adjust the dosage. doi: http://dx.doi.org/10.4021/ jmc1058w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".