Name: Evaluation of Phenobarbital and Benzodiazepine Use for Alcohol Withdrawal Treatment in the Medical Intensive Care Unit
Start: 2025-04-24T16:40:00-0400
End: 2025-04-24T16:55:00-0400

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Thursday April 24, 2025 4:40pm - 4:55pm EDT

Athena I

Title: Evaluation of Phenobarbital and Benzodiazepine Use for Alcohol Withdrawal Treatment in the Medical Intensive Care Unit

Authors: Jessica Schuchardt; Mary Massaro; Benjamin Bevill; Micaela Seazzu; Robert Heidel; Madison Booker; Ashtyn Keller; Shauna Winters

Objective: This study aims to compare ICU length of stay for patients receiving phenobarbital and benzodiazepines versus benzodiazepines alone when treating AWS.

Self Assessment Question: Which of the following is not a reason why phenobarbital is considered a safe and effective alternative for alcohol withdrawal syndrome?

Background: There is a high prevalence of alcohol use disorder (AUD) leading to a significant risk of alcohol withdrawal syndrome (AWS) in critically ill patients. However, despite existing guidelines, there is limited evidence on the use of phenobarbital for AWS as part of a standardized protocol for medical intensive care unit (ICU) patients.

Methods: This study was a single-center, retrospective, pre-post analysis that compared pre-pathway patients admitted between January 2017 to January 2020 who received benzodiazepines alone to post-pathway patients admitted between August 2022 to September 2024 who received phenobarbital in addition to benzodiazepines for AWS. Patients were included if they were hospitalized with an ICD-10 code for alcohol withdrawal, admitted to the ICU with medical critical care as the primary team, and, for the post-pathway group, must have received phenobarbital from the pathway. The primary outcome was ICU length of stay, while secondary outcomes included hospital length of stay, incidence and length of mechanical ventilation, cumulative benzodiazepines dose, incidence of delirium, and use of adjunctive medications for AWS.

Results: 132 patients were included in analysis (n= 92 pre-pathway; n=40 post-p

Moderators

Hania Zaki

Pediatric Cardiac Pharmacy Specialist, CHGA1Children's Healthcare AtlantaPGY1

Presenters

Jessica Schuchardt

PGY1 Pharmacy Resident, University of Tennessee Medical Center

Jessica Schuchardt, PharmD is a current PGY-1 Pharmacy Resident at the University of Tennessee Medical Center in Knoxville, TN. Prior to residency she earned her Doctor of Pharmacy from the University of Maryland School of Pharmacy. After the completion of her PGY-1, she will continue... Read More →

Evaluators