Why can’t I get cephalosporin after drinking alcohol? A: Alcohol + cephalosporin = disulfiram-like reaction Disulfiram-like reaction: essentially, it is a kind of poisoning reaction caused by the accumulation of acetaldehyde in the body after the application of drugs and exposure to alcohol. After alcohol enters the body, it is first oxidized to acetaldehyde by the action of ethanol dehydrogenase in hepatocytes, and acetaldehyde is oxidized to acetic acid and acetalase A by the action of acetaldehyde dehydrogenase in mitochondria of hepatocytes, and acetic acid is further metabolized to carbon dioxide and water and excreted out of the body. Because some chemical structures contain side chains of methylthiotetrazole, which inhibit the activity of acetaldehyde dehydrogenase in the mitochondria of hepatocytes, acetaldehyde cannot be further oxidized and metabolized after it is produced, resulting in the accumulation of acetaldehyde in the body and a disulfiram-like reaction. The drugs that cause this reaction are generally in addition to cefoperazone sodium, other cephalosporin antibiotics that contain a methylthiotetrazole substituent can also undergo a disulfiram-like reaction, such as ceftriaxone sodium, cefpodoxime, cefmetazole, and cefotaxime. In addition, metronidazole, tinidazole, furazolidone, ketoconazole, ashwagandha, chloramphenicol, toluenesulfonylurea, glibenclamide, phenelbiguanide and anticoagulants can cause disulfiram-like reactions. The main clinical manifestations: flushing and swelling of the face, dizziness, headache, numbness and weakness of the limbs after drinking alcohol or contact with alcohol-containing food, respiratory distress, chest tightness, palpitations, nausea and vomiting, drop in blood pressure, and even shock in severe cases, easily misdiagnosed as acute coronary syndrome, heart failure, etc. In addition, the severity of disulfiram-like reaction is directly proportional to the dose of applied drugs and the amount of alcohol consumed. Drinking liquor is more severe than beer and alcoholic beverages, and drinking alcohol during the drug administration is more severe than drinking alcohol after stopping the drug. Treatment: Once the diagnosis is confirmed, oxygen, rehydration, intramuscular promethazine, intravenous dexamethasone, high sugar and naloxone are applied to accelerate the metabolism of ethanol; if necessary, dopamine and other vasoactive drugs are given. After active treatment, most patients’ conditions resolved within 1 to 2 hours. If resuscitation is not timely, the patient will die. Prevention: Avoid intravenous drip or oral cephalosporin antibiotics for one week before and after drinking alcohol, avoid taking alcoholic chocolate, patchouli, hydrocortisone, and alcohol baths during the period of static cephalosporin drip, and cephalosporin should be avoided in alcoholics’ visits to the clinic.