Commonly used fluoroquinolones cross-react with urine drug screens for opiates, buprenorphine, and amphetamines

Colby, Jennifer M.; Patel, Pratish C; Fu, Darwin Y.; Rutherford, Nicola J.

doi:10.1016/j.clinbiochem.2019.04.009

Cited by 12 publications

(3 citation statements)

References 13 publications

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“…Fluoroquinolone antibiotics, like moxifloxacin or ofloxacin, are commonly prescribed to treat various infections. A laboratory investigation has confirmed the cross-reactivity and interference of moxifloxacin with the detection of amphetamines in the Abbott MULTIGENT amphetamine/methamphetamine assay [34].…”

Section: Fluoroquinolonesmentioning

confidence: 80%

Guilty or not guilty? — False positive results of common medicines in drug tests: review and practical guide

2023

Folia Medica Cracoviensia

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Drug-abuse detection tests are becoming increasingly commonplace in patient care today and provide a rapid and effective method for identifying illicit substances. Occasionally, they may yield a positive result, indicating the presence of a substance, even though the individual has not consumed the suspected drug what sometimes can significantly impact both medical and legal decisions. The study outlines the substances that can lead to false-positive drug test results for amphetamines, cannabinoids, and benzodiazepines. The study's findings have revealed pivotal insights for patients receiving chronic treatment and their primary care physicians. Notably, amphetamine assays appear to be most prone to cross-reactivity with other substances. The beta-blocker group of medications, confirmed by various studies to interfere with amphetamine assays, could pose a substantial challenge in drug screening given its widespread use. Efavirenz also warrants mention, as it frequently triggers positive results for both benzodiazepine and cannabinoid assays among its users. This research helps highlight new areas for further investigation and aims to guide clinicians in their daily practice, especially when interpreting questionable positive drug-abuse test results. This comprehensive review serves as a valuable resource for clinicians to navigate false-positive scenarios effectively and maintain the highest standard of patient care.

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Section: Fluoroquinolonesmentioning

confidence: 80%

Guilty or not guilty? — False positive results of common medicines in drug tests: review and practical guide

2023

Folia Medica Cracoviensia

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“…There is evidence for these types of occurrences in immunoassays. A recent publication has shown that certain antibiotics (e.g., levofloxacin) can induce false positives in immunoassays designed to detect opiates in urine samples [19,20]. In these urine samples, it is unknown whether antibiotics are present in the samples; it is certainly possible that the false positives observed in this study could have contained one or more of these interfering substances.…”

Section: Discussionmentioning

confidence: 91%

The use of lateral flow immunoassays for the detection of fentanyl in seized drug samples and postmortem urine

Angelini

Biggs

Prugh

et al. 2020

Journal of Forensic Sciences

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The opioid crisis has continued to progress in the United States and the rest of the world. As this crisis continues, there is a pressing need for a rapid and cost‐effective method for detecting fentanyl. Recent studies have suggested that lateral flow immunoassays (LFIs) could fill this technology gap. These qualitative paper‐based assays contain antibodies designed to react with fentanyl and provide positive or negative results within a matter of minutes. In this study, two different LFI configurations for the detection of fentanyl were examined (dipsticks and cassettes) for effectiveness of detection using seized drug samples and postmortem urine samples. In the current study, 44 seized drug samples (32 fentanyl‐positive, 12 fentanyl‐negative) and 14 postmortem urine samples (10 fentanyl‐positive, 4 fentanyl‐negative) were analyzed. All 32 fentanyl‐containing seized drug samples and 10 postmortem fentanyl‐positive urine samples displayed positive LFI results with both LFI configurations. The fentanyl dipsticks displayed a sensitivity of 100%, a specificity of 75%, and an efficiency of 93.2% for seized drug samples and a sensitivity, specificity, and efficiency of 100% for postmortem urine. Analysis of the fentanyl cassettes displayed a sensitivity, specificity, and efficiency of 100% for seized drug samples and a sensitivity of 100%, a specificity of 75%, and an efficiency of 92.9% for postmortem urine samples. These data point to the utility of LFIs as a quick and low resource‐dependent option for presumptive detection of fentanyl in real‐world situations.

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“…A remarkable improvement in the sensitivity of ELISA has been observed by various researchers using spacers between antigens and coupling protein when used as a coating antigen in the antigen immobilized format (14)(15)(16)(17) or between antigen and enzyme when used as an enzyme conjugate in the antibody immobilized format (30,31). It was demonstrated that in the antigen-immobilized format, varying the lengths of the spacer arm of the coating antigen had a significant effect on the sensitivity of ELISA (29,(32)(33)(34)(35)(36). A 19-atom linker, an oligoethylene glycol (OEG), was conjugated between progesterone and ovalbumin (OVA) and used as a coating antigen in the surface plasmon resonance (SPR) flow-through biosensor format.…”

Section: Introductionmentioning

confidence: 99%

Development and optimization of an in-house heterologous ELISA for detection of prednisolone drug in enzyme conjugates using spacers

Kumar,

Oberoi,

Singh

et al. 2023

Front. Immunol.

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The introduction of spacers in coating steroid protein complexes and/or enzyme conjugates or immunogens is known to exert an influence on the sensitivity of steroid enzyme immunoassays. We investigated the impact of different homobifunctional spacers, ranging in atomic length from 3 to 10, on the sensitivity and specificity of prednisolone (PSL) enzyme immunoassays. In this study, four homo-bifunctional spacers, namely, carbohydrazide (CH), adipic acid dihydrazide (ADH), ethylene diamine (EDA), and urea (U), were incorporated between PSL and horseradish peroxidase (HRP) for preparing the enzyme conjugate with an aim to improve the sensitivity of the assay without compromising assay specificity. The assays were developed using these enzymes conjugated with antibodies raised against the PSL-21-HS-BSA immunogen. The sensitivity of the PSL assays after insertion of a bridge in the enzyme conjugate was 1.22 ng/mL, 0.59 ng/mL, 0.48 ng/mL, and 0.018 ng/mL with ADH, CH, EDA, and urea as a spacer, respectively. Among the four combinations, the PSL-21-HS-BSA-antibody with PSL-21-HS-U-HRP-enzyme conjugate gave better sensitivity and less cross-reaction. The percent recovery of PSL from the exogenously spiked human serum pools was in the range of 88.32%-102.50%. The intra and inter-assay CV% was< 8.46%. The PSL concentration was estimated in the serum samples of patients on PSL treatment. The serum PSL values obtained by this method correlated well with the commercially available kit (r2 = 0.98). The present study suggests that the nature of the spacer is related to assay sensitivity and not the spacer length.

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Commonly used fluoroquinolones cross-react with urine drug screens for opiates, buprenorphine, and amphetamines

Cited by 12 publications

References 13 publications

Guilty or not guilty? — False positive results of common medicines in drug tests: review and practical guide

Guilty or not guilty? — False positive results of common medicines in drug tests: review and practical guide

The use of lateral flow immunoassays for the detection of fentanyl in seized drug samples and postmortem urine

Development and optimization of an in-house heterologous ELISA for detection of prednisolone drug in enzyme conjugates using spacers

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