Spectrum: Local Antimicrobial Stewardship, for Markham Stouffville Hospital

SEM Disease

Continue acyclovir

If ocular involvement

Refer to ophthalmologist

AND Administer

Topical ophthalmic solution

i.e. 1% trifluridine solution 4 times a day to the eyes for 5 days

Duration of Initial Treatment

Minimum of 14 days

After Initial Treatment - Oral Suppressive Therapy

Acyclovir 300mg/m2 per dose PO TID x 6 months

Acyclovir is dosed using Body Surface Area
BSA (m2 ) = sqr(Height[cm] * Weight[kg] / 3600)

Notes on Oral Suppressive Therapy

  • After completion of parenteral acyclovir for treatment of neonatal CNS HSV disease, infants should receive oral acyclovir 300mg/m² per dose TID suppressive therapy for 6 months.

  • Acyclovir dose should be adjusted each month to account for growth.

  • Suppressive therapy for SEM or disseminated disease can be offered however, data is less convincing.