Treatment of Herpetic Infections

Valaciclovir is the treatment of choice. Oral therapy is usually adequate but IV aciclovir treatment will be needed for serious infection, e.g. encephalitis or ophthalmic lesions. For topical treatment, there is no good evidence that aciclovir is any better than povidone iodine. Treatment should be given until satisfactory resolution of the lesion(s) has been achieved. Long-term treatment may be needed in some situations.

For more information about oral valaciclovir and IV aciclovir, refer to the Data Sheets on Medsafe.

Herpes Zoster

Intravenous aciclovir is the treatment of choice. To be effective, treatment should be started early, certainly within 48-72 hours of clinical onset.

Dose: 10-12 mg/kg corrected for nearest 250 mg vial three times a day is recommended for IV use. Treatment should be given for at least 7-10 days. Switch to PO valaciclovir when clinically improving.

Oral valaciclovir 1000 mg TDS may be used in patients with uncomplicated shingles.

For more information about oral valaciclovir and IV aciclovir, refer to the Data Sheets on Medsafe.

Aciclovir - Dosage in Renal Impairment

Note: If the creatinine clearance is less than 10 mL/min, seek consultant advice.


About this Canterbury DHB document (5014):
Document Owner:	Andrew Butler (see Who's Who)
Last Reviewed:	May 2021
Next Review:	May 2023
Keywords:
Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer The Haematology Department Protocols and Guidelines (the Red Book) are intended as a guide for registered health professionals to communicate guidelines and share best practices with supporting health professionals within New Zealand district health boards. They are not intended to be provided to or used as a reference for patients or non-registered health professionals. All health professionals must exercise their own clinical judgement and use pertinent clinical data when treating patients. The authors and editors of this publication have checked with sources believed to be reliable in their effort to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical science, neither the authors, editors, publisher, nor any other party who has been involved in preparing or publishing this work warrants that the information contained in it is accurate or complete in every respect. They therefore have no liability (whether in tort (including negligence) or otherwise) for any loss or damage arising out of any reliance on this information. This publication has been compiled by the staff and contractors of Canterbury District Health Board (CDHB) and as such CDHB has copyright for this book. Amendments must be authorised in accordance with the documented process. No release of part of, or all of, this publication to any other party or organisation is permissible without the prior approval of the designated document owner.
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