False-Positive Urine Opiate Screening Associated with Fluoroquinolone Use

Abstract

OBJECTIVE: To review the literature regarding false-positive urine opiate screens associated with the use of fluoroquinolones. DATA SOURCES: Literature was identified using MEDLINE (1966—February 2004), EMBASE, and all EBM Reviews with the terms quinolones, substance abuse detection, opiates, cross-reactions, false-positive reactions, and each fluoroquinolone. Article references were also reviewed. DATA SYNTHESIS: Various settings utilize the practice of screening for drugs of abuse, such as opiates. These screening procedures can impact aspects of one's life, such as employment; therefore, accuracy is of the utmost importance. Two clinical trials were evaluated which showed that certain fluoroquinolone antibiotics cross-react with some of the commonly used urine opiate screening immunoassays. This suggests the importance of verifying positive results in instances where one's livelihood can be affected. CONCLUSIONS: Fluoroquinolones can cause false-positive urine opiate screens. Clinicians should be aware of this potential interaction and may need to verify positive results.