Ethylglucuronide as a biomarker for ethanol detection

Many different biomarkers can be used to evaluate ethanol intake. Ethylglucuronide, a minor metabolite of ethanol, is a biomarker that is useful in determining ethanol intake up to 80 hours after ethanol consumption. To better understand the utility of this biomarker, a MEDLINE search of ethylglucuronide in the English-language literature from January 1987-August 2007 was performed; clinical trials and case reports were reviewed. In addition, relevant nonmedical media and government documents were reviewed. Ethylglucuronide has an extended window of detection compared with other biomarkers and can be detected in urine I hour after ethanol ingestion. However, incidental exposure to ethanol-containing products may cause false-positive results, and false-negative results have been reported when urine has been infected with certain bacteria that cause urinary tract infections. Before a urine sample is submitted for ethylglucuronide evaluation, a thorough drug history should be obtained. Misinterpretation of ethylglucuronide results can produce serious adverse medical and social consequences. When positive ethylglucuronide screen results are reported, further evaluation of the clinical picture and confirmation with ethylglucuronide quantification and self-report should be instituted. Clinicians should have a thorough understanding of the strengths and weaknesses of the ethylglucuronide test when used in various settings.