Absence of disulfiram-type reactions to single and multiple doses of cefonicid: a placebo-controlled study

Disulfiram-type reactions after ingestion of alcohol have been reported in patients treated with a number of cephalosporin antibiotics; predominantly with agents containing the methylthiotetrazole side chain, although other similar configurations have also been implicated. Since cefonicid has a sulphonic acid thiotetrazole substitution, we investigated the possibility of a cefonicid-ethanol interaction in 15 healthy volunteers. During the first two crossover phases of the study, single 1 g doses of cefonicid followed by ethanol challenges were compared to placebo followed by ethanol challenges. In the third phase, all volunteers received three consecutive 1 g doses of cefonicid given at 24 h intervals followed by an ethanol challenge. At no time did any of the subjects experience a disulfiram-type reaction, and their blood aldehyde concentrations did not increase throughout the study.