Phenobarbital for Alcohol Withdrawal

Clinical Takeaway

: In a before-and-after study, implementing a phenobarbital order set throughout a hospital led to a shorter duration of alcohol withdrawal and shorter hospital stays.

Context

Phenobarbital is used increasingly for alcohol withdrawal syndrome (AWS) in emergency departments (EDs) and intensive care units (ICUs) because of potential pharmacologic advantages over some benzodiazepines, but we have fewer data from other hospital settings. In this observational study, investigators compared outcomes before and after a phenobarbital AWS order set was implemented throughout a 280-bed hospital, including the ED, ICU, and acute-care floors. The study included all 254 hospitalized adults treated for AWS — mostly in non–ICU settings — in the 1 year before or after the order-set implementation. Before the implementation, benzodiazepines were the predominant pharmacologic intervention for AWS at this hospital.

Key Result…

Reviewing Author

Daniel D. Dressler, MD, MSc, MHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)