Disulfiram-like reactions with metronidazole and cephalosporins
Landmark studies and systematic reviews
Key evidence
Klein LR et al. Unsuspected Critical Illness Among Emergency Department Patients Presenting for Acute Alcohol Intoxication. Annals of Emergency Medicine 2018
aOR data for hypoglycemia (9.2), fever (7.6), hypothermia (4.2), hypotension (3.8)
1 per 1,000 intoxicated ED encounters had intracranial hemorrhage
Identified highest-risk alarm features in acute intoxication
Wood E et al. Will This Hospitalized Patient Develop Severe Alcohol Withdrawal Syndrome? JAMA 2018
Rational Clinical Examination systematic review
Prior seizures and DTs strongest predictors of severe withdrawal
Guides PAWSS and clinical risk stratification
Mirijello A et al. Identification and Management of Acute Alcohol Intoxication. European Journal of Internal Medicine 2023
Comprehensive review of severity stratification and management
Supports thiamine-before-glucose protocol
Outlines antiemetic and agitation management evidence
Vonghia L et al. Acute Alcohol Intoxication. European Journal of Internal Medicine 2008
Detailed review of BAC thresholds and clinical correlates
Pharmacokinetics and physiologic effects
Kraut JA, Mullins ME. Toxic Alcohols. New England Journal of Medicine 2018
Osmolal gap calculation and interpretation
Methanol and ethylene glycol management including fomepizole
Hemodialysis indications
Hanalioglu D et al. Acute Alcohol Intoxication-Related Metabolic and Biochemical Disturbances in Adolescents. Clinical Pediatrics 2024
Hypoglycemia 7%, hyponatremia 11% in adolescent cohort
Pediatric-specific metabolic vulnerability data
Díaz LA et al. Management of Alcohol Use Disorder. Lancet Gastroenterology and Hepatology 2025
Current evidence on AUD pharmacotherapy and referral
SBIRT model evidence in ED setting
Haber PS. Identification and Treatment of Alcohol Use Disorder. New England Journal of Medicine 2025
Comprehensive AUD management review
Naltrexone, acamprosate, disulfiram evidence for outpatient follow-up
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