A series of acute reactions caused by drinking alcohol after the application of cephalosporin antibiotics are getting more and more attention. Although there have been a considerable number of clinical reports at home and abroad, most people still lack awareness of this serious adverse reaction, including clinicians, so it is necessary to introduce the relevant knowledge in this regard to everyone. Cephalosporin antibiotics have been widely used in recent years because of their high efficacy and low side effects. However, its structure contains mercaptomethyl tetrazolium substituent, which has the same effect as withdrawal sulfur in human body and can cause bisulfur wake-like reaction. What is a disulfiram-like reaction? Bisulfur sobriety is a drug for alcohol withdrawal, which does not have an effect on the body itself, but when the drug is taken after drinking alcohol, even if a small amount is consumed, the body will experience serious discomfort, making those who have a taste for alcohol averse to alcohol and achieve the purpose of withdrawal. The mechanism of action of disulfiram is to inhibit acetaldehyde dehydrogenase in the liver, resulting in the metabolism of acetaldehyde, an intermediate metabolite of ethanol, being blocked and unable to continue to oxidize to acetic acid, and a small amount of acetaldehyde can be found in the blood of normal people after drinking alcohol. Due to the increase of acetaldehyde concentration in the blood and a series of reactions occur. They are facial flushing, conjunctival congestion, headache, vertigo, nausea, vomiting, hypotension, accelerated heart rate, arrhythmia, respiratory distress, etc. In serious cases, acute congestive heart failure, respiratory depression, loss of consciousness, convulsions, etc. Some drugs, especially cephalosporin antibiotics, can also inhibit acetaldehyde dehydrogenase, leading to reactions similar to disulfiram, which are collectively referred to as disulfiram-like reactions in clinical practice. In patients using cephalosporin antibiotics, 5-10 minutes after drinking alcohol, the face starts to get hot and flushed, the head and neck feel violently throbbing due to the tension of blood vessels throughout the body, and headache is produced, and in heavy cases, there may be sweating, deficiency, drop in blood pressure, irritability, blurred vision, difficulty in breathing, and even shock occurs. The duration of the reaction ranges from 30 minutes to several hours. The severity of the reaction is proportional to the drug and the amount of alcohol consumed, and it is more severe in people who do not drink or who drink very little alcohol. Severe reactions can lead to respiratory depression, vascular deficiency, cardiac arrhythmia, acute congestive heart failure, and even death by convulsions in patients. Therefore, when taking cephalosporin antibiotics, special attention should be paid to avoid the ingredients containing ethanol from entering the body or coming into contact with the skin. Some people abroad remind patients that during the application of cephalosporin antibiotics, that is, the use of alcohol for skin disinfection or alcohol baths, may produce a dithione-like reaction. This is even more alarming for patients with heart disease or cerebrovascular disease. The diagnosis of disulfiram-like reactions is generally not difficult, but attention should be paid to the differentiation from ethanol poisoning, infectious diseases and cardiovascular diseases. Although disulfide-like reactions are pharmacogenic emergencies, no special treatment is generally required, and the symptoms will gradually disappear after discontinuing ethanol. If the symptoms are serious, we can take corresponding measures, we cannot wait for the natural oxidation of acetaldehyde in the body, we should actively treat to shorten the period of hypotension as much as possible, such as maintaining blood pressure, anti-shock, administering oxygen, intravenous fluids, giving high dose of vitamin C if necessary, and pay attention to the determination of blood potassium and blood magnesium to correct low blood potassium and low blood magnesium in time. Specially remind friends is that the insidious adverse drug reactions can still occur after stopping the drug. Therefore, in the 3 —-7 days after stopping the drug, still need to abstain from alcohol and avoid contact with food and drugs containing ethanol. In addition, drugs that can cause dithione-like reactions, such as methotrexate, calcium carbamate, dysentery, and sulfonylurea, also need to be avoided along with alcohol.