Table 6Protocols for symptom-triggered and fixed-dosing regimens

Clinical study protocols for symptom-triggered regimens
Daeppen 2002*Saitz 1994*Weaver 2006*Lange-Asschenfeldt 2003*

> 8: every 30 minutes

< 8: every 6 hours

> 8: hourly

< 8: every 6 hours

> 30: hourly

< 30: every 4 hours

Every 2 hours (day 0–3)

Every 4 hours (day 4–5; mean duration of treatment: 4.2 days)

UK protocols for symptom-triggered regimens
Royal Liverpool and Broadgreen University Hospital Trust**Addenbrookes Hospital*Huntercombe Centre, Sunderland**Greenwich PCT (based on St Thomas' Hospital)*

Hourly (independent of score)

Every 4 hours (when symptom controlled)

0–5: every 4 hours

6–8: every 2 hours

> 9: hourly

< 20: every 4 hours

> 20: hourly

Every 2 hours (only for first 24 hours; followed by a fixed- dosing regimen)

Clinical study protocols for fixed-dosing regimens
Daeppen 2002Saitz 1994Weaver 2006Lange-Asschenfeldt 2003

4 times a day

As-needed medication

4 times a day

As-needed medication

6 times a day

As-needed medication

Day 0–2: 3/4 times

Day 3–4: 2/3 times

Day 5–9: tapered

UK protocols for fixed-dosing regimens
Royal Liverpool Hospital TrustDerby HospitalImperial College Healthcare HospitalUniversity Hospital Bristol

Day 1–3: 4 times

Day 4–6: 3 times

Day 7: 2 times

Day 8–9: 1 time

No PRN

Day 1–5: 4 times

Day 6: 3 times

Day 7: 1 time

No PRN

Day 1–6: 4 times

Day 7: 3 times

Day 8: 2 times

Day 9: 1 time

No PRN

Severe AAW: 1 PRN 1st day

Day 1–5: 4 times

Day 6: 2 times

Day 7: 1 time

2 PRN (day 1 & 2)

Cambridge University HospitalsGreenwich PCT (based on St Thomas' Hosp)Maudsley prescribing guidelineRoyal Free Hampstead NHS Trust

Day 1: 3/4 times + PRN

Day 2: 3 times + PRN

Day 3: 3 times + PRN

Day 4: 2 times + PRN

Day 5: 3 times + PRN

Day 6: 2 times + PRN

Day 7: 1 time, no PRN

Begin after 24 hrs of symptom- triggered

4 times a day

No PRN

Day 1–4: 4 times

Day 5: 2 times

No PRN

Chlordiazepoxide

  • Day 1–4: 4 times + prn
  • Day 5: 2 times + prn
  • Day 6: 1 time + prn

Clomethiazole

  • Day 1–3: 3/4 times + prn (1–2)
  • Day 4–5: 2/3 times + prn (1–2)
  • Day 6–7: Tapered
*

Protocol using the CIWA-Ar scale

**

Protocol using the CIWA-AD scale

From: A.3, Health economic analysis – dosing regimens for acute alcohol withdrawal

Cover of Alcohol Use Disorders
Alcohol Use Disorders: Diagnosis and Clinical Management of Alcohol-Related Physical Complications [Internet].
NICE Clinical Guidelines, No. 100.
National Clinical Guideline Centre (UK).
Copyright © 2010, National Clinical Guidelines Centre.

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