All too often the fruits of modern medicine are blighted by avoidable infection when patients on whom technical skills have been lavished die or lose a benefit they might otherwise have enjoyed. Although such a loss is expensive both in terms of human tragedy and of wasted time and resources, scant attention is paid to its prevention compared with that which goes into the development and use of the advanced techniques which so often bring infections in their train. The intravascular route for biochemical. pharmacological, nutritional and other physiological support and monitoring necessary to patients undergoing many of the demanding modern medical procedures opens a channel through which infection all too easily finds a way. When it does it may be unsuspected and un detected until too late by those whose attention is fixed on the end they seek while forgetting that the means they use can produce preventable disease. The largest medical use of the intravascular route is for 'intravenous therapy'. Lip-service is paid to the idea that this carries a significant morbidity and mortality, but surprisingly little has been done to measure its incidence or design measures to avoid it. In the early 1970s, the medical and pharmaceutical professions, and the lay public, were startled by the realization of the microbiological threat to patients infused with products which had been subject to manufacturing error in their design or pro duction."

For twenty years this book, now in its 5th edition, has provided information on adverse drug interactions that is unrivalled in coverage and scholarship.

Adverse drug reactions, many of them ascribable to interactions with other drugs or with chemical substances in food or the environment, are thought to cause or complicate one in twenty of hospital admissions.

The book is conveniently divided into two parts: Part 1 comments on drug interactions and their mechanisms, on a pharmacokinetic and pharmacodynamic level, while Part 2 consists of drug interaction tables, divided and subdivided into categories of disorders, and the drugs used in the treatment of these disorders.

If safety in drugs is to improve, education of prescribers is vitally important. This book, with its up-to-date and coordinated approach, serves that purpose well. The real threat, as the authors remind us, is the ignorance of practitioners, not the drug itself. The volume is therefore an essential addition to the shelves of those responsible for the prescription of drugs, in order to prevent a potential backlash when used in combination with other drugs or chemical substances.