Drug De-Addiction and Treatment CentreDepartment of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
National Drug De-Addiction and Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
Alcohol Alcohol. 2021 Jan 4;56(1):42-46. doi: 10.1093/alcalc/agaa096.
We conducted a cross-sectional survey to estimate the prevalence and clinical manifestation of disulfiram ethanol reaction (DER) and isopropanol toxicity (IT) in patients with alcohol use disorders, on disulfiram. Alcohol-based hand rub contains either ethanol or isopropanol or both. COVID-19 pandemic has led to wide scale usage of sanitizers. Patients with alcohol use disorders, on disulfiram, might experience disulfiram ethanol like reactions with alcohol-based sanitizers.
We telephonically contacted 339 patients, prescribed disulfiram between January 2014 and March 2020. The assessment pertained to the last 3 months (i.e. third week of March to third week of June 2020).
The sample consisted of middle-aged men with a mean 16 years of alcohol dependence. Among the 82 (24%) patients adherent to disulfiram, 42 (12.3%) were using alcohol-based hand rubs. Out of these, a total of eight patients (19%; 95% CI 9-33) had features suggestive of DER; four of whom also had features indicative of IT. Five patients (62.5%) had mild and self-limiting symptoms. Severe systemic reactions were experienced by three (37.5%). Severe reactions were observed with exposure to sanitizers in greater amounts, on moist skin or through inhalation.
Patients on disulfiram should be advised to use alternate methods of hand hygiene.
我们进行了一项横断面调查，以估计在使用戒酒硫的酒精使用障碍患者中双硫仑乙醇反应（DER）和异丙醇毒性（IT）的患病率和临床表现。酒精基洗手液中含有乙醇或异丙醇或两者兼有。COVID-19 大流行导致了消毒剂的广泛使用。使用戒酒硫的酒精使用障碍患者可能会在使用酒精基洗手液时出现双硫仑样乙醇反应。
我们通过电话联系了 339 名 2014 年 1 月至 2020 年 3 月期间被开处戒酒硫的患者。评估内容涉及过去 3 个月（即 2020 年 3 月第三周至 6 月第三周）。
该样本由中年男性组成，平均酒精依赖 16 年。在 82 名（24%）坚持使用戒酒硫的患者中，有 42 名（12.3%）正在使用酒精基洗手液。在这些患者中，共有 8 名（19%；95%CI9-33）出现了提示 DER 的特征；其中 4 人还出现了 IT 的特征。5 名患者（62.5%）出现了轻度和自限性症状。3 名患者（37.5%）出现了严重的全身反应。在接触更多量的消毒剂、湿润皮肤或通过吸入时，会观察到严重的反应。
应建议使用戒酒硫的患者使用替代方法进行手部卫生。
