Antabuse Reaction With Ceftin

To the Editor: The antibiotic Ceftin is cefuroxime axetil (1) ; the axetil is converted to acetaldehyde (1) . I recently encountered the following disulfiram reaction.

This reaction was presumably caused by the accumulation of acetaldehyde (alcohol is converted to acetaldehyde; disulfiram blocks the conversion of acetaldehyde to acetate, and a disulfiram reaction is caused by increased acetaldehyde levels). Odyssey Pharmaceuticals (makers of Antabuse) had no reports of an interaction between Ceftin and Antabuse, but very small amounts of alcohol can cause a disulfiram reaction, so it might be assumed that even smaller amounts of acetaldehyde can do the same.