Cephalosporins Reaction to alcohol

An explanation is ollered for the disulfiram-like reaction to alcohol experienced by some patients taking cephalosporins with a methyltelrazolethiol side chain. 5, 51-

dithiobis (1·methyltetrazole) resembles disulfiram both in chemical structure and in its rapid inactivation of cytoplasmic aldehyde dellydrogenase. It is pOSited that the methyltetrazolethiol side chain 01 cephalosporins is oxid ised in vivo to 5, 51·d ithiobis (1-methyltetrazole) which reduces aldehyde dehydrogenase activity and results in the accumulation of acetaldehyde when ethanol is present - a similar action to that of disulfiram. Kitson, T M: lancet 2 1338 (8 Dec r984)