2025 Southeastern Residency Conference

Title: Comparison in Clinical Outcomes with Lorazepam vs. Midazolam use in Patients Admitted to a Community Hospital for Alcohol Withdrawal


Authors: Caitlin Ferguson, Stephen Melton


Background: Alcohol withdrawal is an urgent medical condition which occurs when an individual disrupts or discontinues regular alcohol consumption. The Clinical Institute Withdrawal Assessment for Alcohol (CIWA) is a widely used tool for assessing the severity of alcohol withdrawal symptoms and guiding treatment (1). Current guidelines state longer acting benzodiazepines are preferred due to clinical benefits and longer duration of action (2). Recent drug shortages have led to a shift toward using alternative medications such as midazolam in place of the traditional protocolized lorazepam. By comparing outcomes of each benzodiazepine, healthcare providers can make informed decisions about treatment alternatives.  


Methods: Baptist Health Lexington implemented a protocol to utilize midazolam in lieu of lorazepam during a period of drug shortage. This retrospective study analyzes local clinical outcome data comparing the use of lorazepam and midazolam in patients with alcohol withdrawal before and after the ASHP-designated lorazepam drug shortage in February 2023. Data will be analyzed via review of hospital electronic medical record six months prior and six months after the protocol initiation. The primary outcome is to evaluate the differences in hospital length of stay in number of days for each treatment regimen. The following secondary outcomes will also be assessed: maximum and average CIWA score, total number of lorazepam equivalents administered, and ICU length of stay. Appropriate statistical tests will then be analyzed to assess the clinical outcomes of the two medications. The data collected will be de-identified from individual patient charts and presented only in aggregate.  


Results: In progress 


Conclusions: In progress