Gatifloxacin interference with opiate urine drug screen

Pharmacotherapy
Craig M StraleyMark P Herriman

Abstract

A 48-year-old man participating in a residential treatment program was treated with gatifloxacin for a urinary tract infection. While taking the antibiotic, two urine screens were positive for opiates; results of previous urine opiate screens had been negative. Confirmatory tests using a different assay method, however, gave negative results for opiates. Two weeks after completing gatifloxacin therapy, the patient's urine screen was negative for opiates. Application of the Naranjo adverse drug reaction probability scale indicated that gatifloxacin probably was associated with this patient's positive urine opiate screen. Fluoroquinolones as a class are among several compounds that have demonstrated a propensity to cross-react with enzyme immunoassay urine drug screens for opiates. Occurrence of cross-reactivity appears to vary among individual assays. The mechanism by which fluoroquinolones cross-react with the immunoassay is unknown. Falsepositive results could have negative effects on patient care, and ramifications of a positive drug screen include possible dismissal from a substance abuse treatment program. Confirmatory analysis using a different assay method is therefore necessary to verify the presence of the target drug.

References

Feb 1, 1985·Forensic Science International : Synergy·G Fritschi, W R Prescott
Aug 1, 1981·Clinical Pharmacology and Therapeutics·C A NaranjoD J Greenblatt
Feb 1, 1997·Therapeutic Drug Monitoring·R Meatherall, J Dai
Jan 5, 2002·JAMA : the Journal of the American Medical Association·L R BadenG M Eliopoulos
Jul 15, 2004·The Annals of Pharmacotherapy·Jennifer L Zacher, Donna M Givone

❮ Previous
Next ❯

Citations

Oct 7, 2010·Journal of Addictive Diseases·Peter L Tenore
Sep 30, 2010·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Qaiser Shafiq, Anand Mutgi
Jun 12, 2009·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Milton Tenenbein
Jul 1, 2008·General Hospital Psychiatry·Boonsong KiangkitiwanBrian Bohner
Oct 5, 2013·Clinica Chimica Acta; International Journal of Clinical Chemistry·Yan Zhang, Tai C Kwong
Apr 22, 2011·Journal of Pharmacy Practice·Charles HerringCynthia Johnston
Aug 7, 2010·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Nancy C BrahmTony A Palmer

❮ Previous
Next ❯

Related Concepts

Related Feeds

Addiction

This feed focuses mechanisms underlying addiction and addictive behaviour including heroin and opium dependence, alcohol intoxication, gambling, and tobacco addiction.