Herpes Simplex - Orofacial/Genital

• Treatment works best if given within 72 hours of diagnosis.
• Primary attacks – patients benefit from treatment.
• Secondary attacks – minor recurrence may not need treatment. Patients requiring treatment may be best managed by self-administering a course at the first sign of recurrence.
• Frequent attacks – patients may need prophylactic therapy. Contact Infectious Diseases/Sexual Health.
• Severe infection (e.g. in patients who are immunocompromised or diabetic) – IV aciclovir may be necessary. Consult Infectious Diseases.
• Topical treatment is not routinely recommended as benefits are doubtful.

Pathogen

• H. simplex

Drug Treatment

• Duration: see below

Primary infection

• fe (aciclovir – active metabolite) = 0.8, consider adjusting dose if reduced GFR.

OR

aciclovir HMLSchedNZFPMLnoids Aciclovir F: 0.2 Half life: 3 hours Elimination: renal fe: 0.8

PO 400 mg three times a day for 5 days

• fe (aciclovir – active metabolite) = 0.8, consider adjusting dose if reduced GFR.

Secondary attack (recurrence)

• fe (aciclovir – active metabolite) = 0.8, consider adjusting dose if reduced GFR.

OR

• fe = 0.8, consider adjusting dose if CrCl is reduced.

Topic Code: 99253

must be prescribed or recommended by a consultant.