Varicella Zoster (Shingles)

Pathogen

Varicella zoster

Drug Treatment

• Treatment gives most benefit to patients who are immunocompromised, > 50 years, in severe pain and if treatment begins < 72 hours after onset of symptoms.
• Criteria for complicated disease include:
  • severe immunocompromise (e.g. post organ or bone marrow transplant)
  • disseminated disease
  • ophthalmic involvement (refer to ophthalmology)
  • central nervous system involvement

Empiric

Uncomplicated 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 800 mg five times a day for 7 days

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

Complicated infection

• fe = 0.8, consider adjusting dose if CrCl is reduced.
• Risk of crystal nephropathy, particularly with IV therapy. Maintain adequate hydration and monitor renal function.

Topic Code: 99269

must be prescribed or recommended by a consultant.