Acyclovir tablets are available as 200 mg, 400 mg, and 800 mg sizes. Pharmacokinetic data were available for one patient, and acyclovir exposure after the initial valacyclovir dose was 4,288 uMmin, similar to the group mean. The dosage of oral acyclovir is 20 mg per kg per dose, four times a day, up to 800 mg per dose. 0 to 7 days. Reassess after 12 months. The usual suppressive dosage is 30 mg/kg/day (maximum: 2400 mg/day). Document Control. 16 For pediatric patients, adjustments for weight and other factors must be made. INDICATION Prophylaxis Immunocompetent AGE DOSE DURATION Herpes Simplex Virus(11) - Suppressive therapy (frequent, severe recurrences) 4 weeks to 18 years Oral: 10mg/kg/dose (to a maximum of 400mg) 12 hourly Consider valaciclovir in children 3 months 6 months then review Children: Prophylaxis Immunocompromised Have your child leave the tablet in place until it dissolves. MeSH terms Cephalexin No neonatal dosing available Treatment for skin/soft tissue infections (MSSA infections): 50 mg/kg/day divided q6-8 hours UT Prophylaxis: 10-20 mg/kg/dose PO QHS 1st generation cephalosporin Can alternate with or change to Bactrim at 2 months of life for UTI prophylaxis Clindamycin 5 to 7.5mg/kg/dose IV, PO By intravenous infusion. randomly assigned to oral acyclovir 300 mg/m 2 per dose three times per day or placebo immediately following parenteral acyclovir treatment . Mean half-life after oral doses of 300 mg/m. Pediatric Acyclovir pharmacokinetics were determined in 16 pediatric patients with normal renal function ranging in age from 3 months to 16 years at doses of Medical information for Valacyclovir on Pediatric Oncall including Mechanism, Indication, Contraindications, Dosing, Adverse Effect, Interaction, Renal Dose, Hepatic Dose. Dry your hands and place the tablet in your childs mouth above the incisor tooth between the upper cheek and gum. Put on the same side of the mouth as the cold sore. Antiviral prophylaxis Antimicrobial Dosing Patient population When this should be used Drug monitoring Adverse reactions Dosage Forms Acyclovir IV: 5-10 mg/kg/dose q8h (administer with IV fluids to Dosing : Chickenpox: 2 years: Safety and efficacy not established. 2. and 600 mg/m. After intracellular uptake, it is converted to acyclovir monophosphate by virally-encoded thymidine kinase. 10 mg/kg/dose q8h HSV Infection < 3 mo. Adequate corneal tissue levels (demonstrated by aqueous humor concentrations greater than the median effective dose (ED50) have been reported with both topical trifluridine solution and acyclovir ointment, 211-214 as well as systemic acyclovir and valacyclovir. CDC recommends that clinicians who treat children aged 3-11 months administer 3 mg/kg/dose orally twice per day for treatment, and 3 mg/kg/dose orally once per day for chemoprophylaxis. For topical dosage form (ointment): For herpes simplex infection: In the U.S. AdultsApply to the affected area(s), every three hours, for a total of six times a day, for seven days. LOUIS CHILDRENS HOSPITAL Gentamicin 2.5 mg/kg/dose IV q8h (max: 150 mg/dose) Prophylaxis: Grade I: 24-48 hrs Grade II/III: 48-72 hrs Antibiotic prophylaxis should not extend >24 Acyclovir 10 mg/kg/dose IV q8h 21 days minimum (repeat Children 2-12 years: 75 mg/kg/day PO in 5 divided doses for 5-7 days. Prophylaxis and treatment for HSV and treatment of varicella and herpes zoster infection in immunocompromised patient then oral treatment dose for 5 days . This study suggests that low-dose acyclovir prophylaxis may be effective for preventing HSV and VZV disease after auto-HCT. Maximum dosage: 1 g orally 3 times a day. Max: 1000 mg/day. Dose Adjustment. Background: Acyclovir represents the first-line prophylaxis and therapy for herpes virus infections. Controlled trials 2 to less than 18 years: 20 mg/kg orally 3 times a day for 5 days. 20 mg/kg/dose q8h Adjust for. Maximum Dose. Pediatric Hematology-Oncology Antimicrobial Prophylaxis Guideline Approved by UCDH Pharmacy and Therapeutics Committee 10/2019. Acyclovir IV Mucocutaneous HSV Infection. Reconstitute vial with 10 mL water for injection = 25 mg/mL. The study was aimed at investigating the population pharmacokinetics (POP/PK) of intravenous (IV) acyclovir in oncologic children. However, its pharmacokinetics in children exposes them to the risk of ineffective or toxic concentrations. 5 mg/kg/dose q8h CNS HSV Infection >= 3 mo to < 12 yo. Infectious Diseases. Acyclovir (9- [2-hydroxymethyl]guanine) is a nucleoside analog that selectively inhibits the replication of herpes simplex virus types 1 and 2 (HSV-1, HSV-2) and varicella-zoster virus (VZV). Child 217 years. Preparations. ChildrenUse and dose must be determined by your doctor. Refrigeration may cause crystallisation. patients receiving acyclovir. However, its pharmacokinetics in children exposes them to the risk of ineffective or toxic concentrations. 6 months & <33 kg: 8 mg/kg/dose IV q8h (max: 300 mg/dose) 33 kg: 300 mg IV q8h <6 months: 4 mg/kg/dose IV q8h. Dosage forms: CAP: 200 mg; TAB: 400 mg, 800 mg; SUSP: 200 mg per 5 mL; INJ: various neonatal HSV infection [3 mo, 35 wk gestation] Dose: 40 mg/kg/day IV divided q12h x14-21 days; Info: give x21 days in CNS or disseminated dz [3 mo, 35 wk gestation and older] MD 3-12mg/kg/dose Q24H Prophylaxis 3-6mg/kg/dose Q24H 3-6mg/kg/dose Q24H cr No change 3-6mg/kg/dose Q24H No change LD 800mg Q24H then MDF/N, 400mg Q24H Prophylaxis 200mg-400mg Q24Hcr Ganciclovir Induction Maintenance Clcr 70: 5mg/kg/dose Q12H Clcr 50-69: 2.5mg/kg/dose Q12H Clcr 25-49: 2.5mg/kg/dose Q24H Children up to 12 years of ageDose is based on body weight and must be determined by the doctor. In children with CNS involvement, acyclovir suppression was associated Acute viral encephalitis in children: Treatment and prevention Shortages of IV acyclovir have occurred. Treatment: 12 mg/kg/dose. acyclovir. Withdraw required dose (exact dose) using a 10 mL syringe. Usual Pediatric Dose for Herpes Zoster - Prophylaxis. Peds Dosing . Prophylaxis: 6 mg/kg/dose. In Canada The cumulative incidence of VZV disease was 25.8, 7.7, and 0.0 % at 1 year, respectively. Genital herpes: Typical initial dosage: 200 mg every 4 Go to: DISCUSSION Acyclovir is routinely used in the prophylaxis and treatment of HSV and VZV infections in immunocompromised pediatric patients. ChildrenUse and dose must be determined by your doctor. Child 123 months. Taketomo CK, Hodding JH, Kraus DM. Due to the lack of data for acyclovir prophylaxis in patients with HIV, other experts consider it prudent to wait until rash appears to begin acyclovir treatment. Expert Opinion. 4.0 Approval date 28/04/2022 Executive sponsor Executive Director of Medical Services Effective date 28/04/2022 Author/custodian Director of Infection Management and Prevention service, Immunology and >12 years: 1000 mg/day in 5 divided doses for 7 to 10 days. A Wessley immune ring is seen in this case of HSV disciform keratitis. q48h > 14 days. Dosage in the paediatric population: Treatment of herpes simplex infections, and prophylaxis of herpes simplex infections in the immunocompromised: children aged two years and over should be given the adult doses and children below the age of two years should be given half the adult dose. 215, 216 Whereas oral acyclovir in a dosage of 400 mg five times daily provides therapeutic levels in the PRECAUTIONS . Dosage adjustments are not required for Child-Pugh B or C cirrhosis 8. The study was aimed at investigating the population pharmacokinetics (POP/PK) of intravenous (IV) acyclovir in oncologic children.Methods: In adults, the oral treatment protocol for HSV keratitis is acyclovir 400 mg by mouth five times per day. For IV use: if using powder for reconstitution. It is beneficial in treating infectious epithelial keratitis and prophylactically either while treating with topical corticosteroids for immune stromal keratitis or for preventing recurrent infectious epithelial keratitis. Adult dosage (ages 1864 years) Shingles typical dosage: 800 mg every 4 hours, five times per day for 710 days. Pediatric and Neonatal dosage handbook with q48h > 7 days. Acyclovir for injection is available in a 50 mg/ml concentration.3 Parenteral Dosing The acyclovir regimen for neonatal HSV in the Buccal tablets: Use within 1 hour after the first signs of a cold sore. Renal Dosing: HSV Epithelial Keratitis (Dendritic) Oral Antiviral Creatinine Clearance (ml/min) Dose Frequency Acyclovir Normal Dosage 400 mg 35 times daily > 25 400 mg 35 times daily 1025 400 mg Every 8 hours 010 400 mg Every 12 hours Famciclovir Normal Dosage 250 mg 23 times daily 4059 250 mg Every 12 hours Dosing Recommendations Acyclovir (Zovirax ; GlaxoSmithKline or generic) is available in 200 mg capsules, 400 and 800 mg tablets, and a 200 mg per 5 ml suspension. Usual Dose. Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised Children Document ID CHQ-GDL-01075 Version no. Prophylaxis: 6 mg/kg/dose. 100 mg 5 times a day usually for 5 days (longer if new lesions appear during treatment or if healing incomplete). 200 mg 5 times a day usually for 5 days (longer if new lesions appear during treatment or if healing incomplete). Comments: -Therapy should be started at the earliest sign/symptom of chickenpox, within 24 hours after onset of rash. 200mg, 400mg tablets, 200mg dispersible tablet, 250mg injection BNF for Children 2012, F Shann 2010, Paediatric Dosage Handbook 16th edition. Suppression, chronic (cutaneous, ocular) episodes: 2-12 years: Oral: 30 mg/kg/day in 3 divided doses daily; Maximum dose: 1000 mg/day. 15 mg/kg/dose q8h CNS HSV >= 12 yo, HSV in Immunocompromised Host, or VZV Infection. Background: Acyclovir represents the first-line prophylaxis and therapy for herpes virus infections. The usual dose is 5 to 10 mg of acyclovir per kg (2.3 to 4.5 mg per pound) of body weight, injected slowly into a vein over at least a one-hour period, and repeated every eight hours for five to ten days. Infants aged younger than 3 months are recommended to receive 3 mg/kg/dose orally twice per day for treatment. High dose steroids3 No routine prophylaxis No routine prophylaxis TMP-SMX (Bactrim) DS 3 times weekly Acyclovir 400 mg PO BID Throughout all chemotherapy cycles Proteasome inhibitors (e.g., bortezomib, carfilzomib, No routine prophylaxis No routine prophylaxis Acyclovir 400 mg PO BID Throughout all chemotherapy cycles and continuing for at has occurred in immunocompromised patients receiving acyclovir therapy. Usual Pediatric Dose for Varicella-Zoster. Our findings support the recommendation of acyclovir prophylaxis within the first year after auto-HCT. Withdraw 5 mL of 25 mg/mL solution from vial and add to 20 mL of sodium chloride 0.9% in a 20 mL syringe = 125 mg in 25 mL = 5 mg/mL. The range that was used in the study by Gary Figure 2. In general, the pharmacokinetics of acyclovir in pediatric patients is similar to that of adults. Treatment: 12 mg/kg/dose. q24h Gentamicin IV or Tobramycin IV Use a longer dosing interval for neonates with HIE or significant asphyxia e.g. q24h > 29 to < 45 weeks. 2. SAN FRANCISCO-Low-dose intravenous acyclovir (Zovirax) provideseffective prophylaxis against Herpes simplex virus (HSV)infection or reactivation in leukemic patients undergoing intensivechemotherapy, Carole Miller, MD, said at the 35th InterscienceConference on Antimicrobial Agents and Chemotherapy (ICAAC).. Furthermore, using IV acyclovir at HIV-Infected Children or Adolescents (guideline dosing): Post-exposure Prophylaxis in HIV-Infected Children or Adolescents: 20 mg/kg orally 4 times a day (maximum dose 800 mg) for 7 days beginning 7 to 10 days after exposure Comments: 6 months & <33 kg: 12 mg/kg/dose IV q8h (max: 400 mg/dose) 33 kg: 400 mg IV q8h <6 months: 6 mg/kg/dose IV q8h. no routine prophylaxis mold-active prophylaxis if 1 mg/kg/day prednisone equivalents for 2 weeks (threshold not well defined, consider patient-specific risk factors) consider during treatment course (threshold not well defined, increased risk with 10 mg/day prednisone equivalents) prophylaxis if 20 mg/day prednisone equivalents for 4 Acyclovir therapy is not indicated in pregnant women or in infants less than two years of age. Immunocompetent Host 3 mo. Conclusions: Oral acyclovir is useful in treating HSV infectious epithelial keratitis in pediatric patients. Skin/soft tissue, urinary tract infections <6 months: 8 mg/kg/dose IV q8h. Dosage adjustment is recommended when administering ZOVIRAX to patients with renal Acyclovir is a potent and specific antiviral agent that is effective in the treatment of and prophylaxis against nonocular HSV infection. Usual dosage:2-4 Children and adolescents <60 kg: 5-6 mg/kg every 12 hours as needed (maximum dose 1,000 mg/day) Children and adolescents >60 kg: 250-375 mg every 12 hours as needed (maximum dose 1,000 mg/day) Endocarditis prophylaxis: children <45 kg, 2.2 mg/kg; children >45 kg, 100 mg 30-60 minutes before procedure.7 Metronidazole