Introduction Harmful drinking is endemic in the UK and is a worrying health hazard. It is estimated that up to 24% of the UK adults drink in a hazardous/harmful way.¹ Recent survey shows that up to 35% of the A&E attendance is due to alcohol related,² leading into huge financial implications.³ NICE guidance published in 2010 recommends a symptom triggered regime for patient admitted to hospital with alcohol withdrawal symptoms (AWS).

Aims/Background This Study is designed to compare the effect of symptom triggered regime (STR) using CIWA tool against fixed dose regime (FDR) in patients treated for AWS.

Method Retrospective data collection on 60 patients who were admitted with AWS over a 24 months period. 30 were actively managed in a Gastroenterology Ward where STR was used. The other 30 patients were chosen from General Medical Wards where FDR was used.

Results The mean length of stay for the STR group as calculated was 7.9 days and 10.9 days for the FDR one. 80% of patients in the STR group had a hospital admission of ten days or less where as in FDR group only 46% of patients had this length of stay. The mean total Chlordiazepoxide dose given for the STR group was 264 mg, compared with 501 mg for the FDR group.

Conclusion This audit demonstrates that symptoms triggered regimen leads into a significantly lower total dose of benzodiazepines and a shorter hospital admission. Treatment of symptoms has advantages, both in terms of cost and patient safety.