Pharmacotherapy of acute alcoholic hepatitis in clinical practice

Table 2 Treatment considerations of severe alcoholic hepatitis

Treatment	Options	Comments
Corticosteroids	Prednisolone	If MDF ≥ 32: 40 mg daily orally for 28 d followed by a 2/4-wk taper
Phosphodiesterase inhibitors	Pentoxyfilline	400 mg orally 3 times daily for 4 wk
Anti TNF-α	Infliximab	Infliximab 5 mg/kg iv at day 0 and prednisone 40 mg/d for 28 d (data not confirmed)
Nutrition	Eating, tube feeding	Diet rich in carbohydrate- and protein-derived calories; potassium replacement; vitamin supplementation
Antioxidant	Metadoxine	1500 mg/d orally for 3 mo
Antioxidant	S-adenosylmethionine	1200 mg/d orally in ambulatory patients
Alcohol abstinence	Rehab program disulfiram, naltrexone, acamprosate, baclofen	Reduce alcohol withdrawal symptoms, alcohol craving and intake, promote abstinence, evaluation for OLT program

MDF: Maddrey’s discriminant function; OLT: Orthotopic liver transplantation; TNF-α: Tumor necrosis factor-α.