Disulfiram-like Reaction to -Lactams

Abstract

<h3>To the Editor.—</h3> The letter describing disulfiram-like reactions in subjects taking cefoperazone (1980;243:2397) asked (1) "Which other cephalosporins might also produce this reaction?" and (2) "Is acetaldehyde increased during these reactions?" In other reports, disulfiram-like reactions are described in subjects taking cefoperazone,^1,2moxalactam disodium,³and cefamandole sodium.⁴Disulfiram-likereactions have also occurred in two subjects who ingested alcohol after completing a multiple-dose study with moxalactam in the Lilly Laboratory for Clinical Research, Wishard Memorial Hospital. These subjects received intravenous doses of 4 g of moxalactam disodium every eight hours for seven doses. About 30 hours later, one subject ingested alcohol and within one-half hour had facial flushing, nausea, vomiting, and dizziness. After he fainted and was brought to the hospital, his blood alcohol concentration was 64 mg/dL. His blood pressure was 90/60 mm Hg in the supine position, and his pulse rate was 100 beats per minute