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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 32, Number 4, May,
pp.315-318
SHORT COMMUNICATION:
Failure of Amoxicillin to Produce False-Positive Urine Screens
for Cocaine Metabolite
Gary M. Reisfield1, Judella Haddad1,
George R. Wilson1, Laura M. Johannsen3, Kathryn
L. Voorhees3, Chris W. Chronister4, Bruce
A. Goldberger4, James D. Peele5, and Roger
L. Bertholf2,
Departments of 1Community Health and Family Medicine and
2Pathology, University of Florida Health Science Center, Jacksonville, Florida;
3Shands Jacksonville Medical Center Clinical Laboratories, Jacksonville, Florida;
4Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, Florida; and
5Baptist Medical Center Clinical Laboratories, Jacksonville, Florida
Amoxicillin has been causally linked in the lay
and medical literature to false-positive urine drug screens for
cocaine metabolites. An exhaustive search of the peer-reviewed
medical literature revealed no data to support this link. We
hypothesized that amoxicillin does not cause false-positive urine
drug screens for cocaine metabolites. To test this hypothesis,
we examined the urine of 33 subjects administered a course of
amoxicillin, subjecting the specimens to four common urine screening
immunoassays. Thirty-one specimens were negative for the cocaine
metabolite, benzoylecgonine (BE), by all four screening methods;
two were positive for BE by all four screening methods. Both
positive specimens were confirmed by gas chromatography–mass
spectrometry (GC–MS) for the presence of BE at > 150
ng/mL. Three specimens that screened negative, but produced absorbance
values that were intermediate between negative and positive controls,
were submitted for GC–MS analysis; BE was detected in all
three specimens at concentrations of 54, 94, and 119 ng/mL. Twenty-eight
specimens produced screening results indistinguishable from negative
controls. Within the limitations of the study design, we conclude
that amoxicillin is unlikely to produce false-positive urine
screens for cocaine metabolites.
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