Treatment of herpes simplex encephalitis (HSE)* (assuming normal renal function and hydration)7 9 10
| Birth to 3 months | All children >3 months | |
|---|---|---|
| Intravenous aciclovir 20 mg/kg TDS for at least 21 days | Intravenous aciclovir 3 months to 12 years: 500 mg/m2 TDS for 21 days Over 12 years: 10 mg/kg TDS for 21 days |
| Prophylaxis against HSE recurrence | ||
|---|---|---|
| Birth to 3 months | Immunocompetent children >3 months | Immunocompromised children >3 months |
| Aciclovir per os (PO) 300 mg/m2 TDS for at least 12 months7 Oral vacaciclovir: Not recommended—no neonatal data | Aciclovir PO 300 mg/m2 TDS for at least 3 months OR 1340 mg/m2 BD for at least 3 months11 Valaciclovir PO: 1 month to 12 years 25–40 mg/kg TDS for at least 3 months | Aciclovir PO 300 mg/m2 TDS for at least 12 months OR 1340 mg/m2 BD for at least 12 months11 Valaciclovir PO: 1 month to 12 years 25–40 mg/kg TDS for at least 12 months |
*Dosing information: oral aciclovir is available as suspension at either 400 mg/5 mL (preferred) or 200 mg/5 mL. It is also possible to use reconstituted dispersible tablets (200 and 400 mg available). For valaciclovir, there is no approved liquid preparation. A palatable, red suspension can be prepared by pharmacists from crushed tablets (shelf life under refrigeration=28 days).
BD, twice daily; TDS, three times daily.