{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:30:41Z","timestamp":1791862241195,"version":"4.3.4"},"reference-count":43,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2017,7,17]],"date-time":"2017-07-17T00:00:00Z","timestamp":1500249600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hosp Pharm"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    Benzodiazepines are the drug of choice for alcohol withdrawal syndrome (AWS); however, phenobarbital is an alternative agent used with or without concomitant benzodiazepine therapy. In this systematic review, we evaluate patient outcomes with phenobarbital for AWS.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Medline, Cochrane Library, and Scopus were searched from 1950 through February 2017 for controlled trials and observational studies using [\u201cphenobarbital\u201d or \u201cbarbiturate\u201d] and [\u201calcohol withdrawal\u201d or \u201cdelirium tremens.\u201d] Risk of bias was assessed using tools recommended by National Heart, Lung, and Blood Institute.\n                    <jats:bold>Results:<\/jats:bold>\n                    From 294 nonduplicative articles, 4 controlled trials and 5 observational studies (n = 720) for AWS of any severity were included. Studies were of good quality (n = 2), fair (n = 4), and poor (n = 3). In 6 studies describing phenobarbital without concomitant benzodiazepine therapy, phenobarbital decreased AWS symptoms (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .00001) and displayed similar rates of treatment failure versus comparator therapies (38% vs 29%). A study with 2 cohorts showed similar rates of intensive care unit (ICU) admission (phenobarbital: 16% and 9% vs benzodiazepine: 14%) and hospital length of stay (phenobarbital: 5.85 and 5.30 days vs benzodiazepine: 6.64 days). In 4 studies describing phenobarbital with concomitant benzodiazepine therapy, phenobarbital groups had similar ICU admission rates (8% vs 25%), decreased mechanical ventilation (21.9% vs 47.3%), decreased benzodiazepine requirements by 50% to 90%, and similar ICU and hospital lengths of stay and AWS symptom resolution versus comparator groups. Adverse effects with phenobarbital, including dizziness and drowsiness, rarely occurred.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Phenobarbital, with or without concomitant benzodiazepines, may provide similar or improved outcomes when compared with alternative therapies, including benzodiazepines alone.\n                  <\/jats:p>","DOI":"10.1177\/0018578717720310","type":"journal-article","created":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T07:08:06Z","timestamp":1507619286000},"page":"607-616","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":42,"title":["Patient Outcomes Associated With Phenobarbital Use With or Without Benzodiazepines for Alcohol Withdrawal Syndrome: A Systematic Review"],"prefix":"10.1177","volume":"52","author":[{"given":"Drayton A.","family":"Hammond","sequence":"first","affiliation":[{"name":"University of Arkansas for Medical Sciences, Little Rock, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan M.","family":"Rowe","sequence":"additional","affiliation":[{"name":"University of Tennessee Medical Center, Knoxville, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Wong","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa L.","family":"Wiley","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center, Omaha, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Orlando Regional Medical Center, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra L.","family":"Kane-Gill","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Pharmacy, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,7,17]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"National Institute of Alcohol Abuse and Alcoholism. http:\/\/pubs.niaaa.nih.gov\/publications\/AlcoholFacts&Stats\/AlcoholFacts&Stats.htm. 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