"Antibiotics" - Viral

Infection

Herpes simplex -mouth / lips

Initial episode (immunocompetent):

Valaciclovir 500mg q12h po x 5-10 days

Recurrent episode (immunocompetent):

Valaciclovir 500mg q12h po x3-5 days.

Alternative regimen in immunocompetent patients:

Valaciclovir 2g q12h po x1 day.

Immunocompromised patients:

Valaciclovir 1g q12h po x 5-10 days.

Initial episode (immunocompetent): 5-10 days

Recurrent episode:(immunocompetent) 3 - 5 days

Alternative regimen in immunocompetent: 1 day

Immunocompromised patients: 5 - 10 days

Infection

Genital herpes

Initial episode (immunocompetent):

Valaciclovir 500mg q12h po x 5 days.

Recurrent episode (immunocompetent):

Valaciclovir 500mg q12h po x 3 days.

Immunocompromised patients:

Valaciclovir 1g q12h po x 5-10 days.

Initial episode (immunocompetent): 5 days.

Recurrent episode (immunocompetent): 3 days.

(Consider providing patients with a prescription or supply to commence promptly at the onset of symptoms of recurrent episodes).

Immunocompromised patients: 5-10 days.

Infection

Herpes simplex encephalitis

Aciclovir 10mg/kg q8h iv.

↓ dose in renal impairment.

Check dosing.

Use Ideal Body Weight

IBW ♂ = 50kg + [(height (cm) -154) x0.9]

IBW ♀ = 45.5kg + [(height (cm) -154) x0.9]

Infection

Herpes zoster opthalmicus

Valaciclovir 1g q8h po.

Consider referral to ophthalmology.

If sight is threatened, use IV acyclovir 10mg/kg q8h iv.

Use IBW to calculate dose and check Creat. Clearance. Check ↓dose in renal impairment.

Infection

Herpes zoster (shingles)

Valaciclovir 1g q8h po*.

7 days.

Please see EMed.ie: Shingles for more clinical advice and patient information.

Infection

Varicella zoster (chicken pox)

VZV

Valaciclovir 1g q8h po.

Consider Varicella zoster immunoglobulin in immunocompromised patients / pregnancy.

Consider vaccination of susceptible adults and children.

Consider Varicella zoster immunoglobulin in immunocompromised patients / pregnancy.

Consider vaccination of susceptible adults and children.

Patients with high risk of severe disease: Aciclovir 10mg/kg q8h iv*