Spectrum: Local Antimicrobial Stewardship, for Alberta Children's Hospital

Acyclovir

C. diff Risk

None

Oral Bioavailability

NA

Approximate Cost

IV$45/d PO$5/d

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Renal

Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.

Neonatal

General Pediatric

PO Mild/Moderate

Varicella: 80mg/kg/DAY divided q6h

HSV mucocutaneous inf: 40-80mg/kg/DAY divided q6-8h

HSV prophylaxis: 300mg/m2/DOSE q8h

General Information

Common Usage

Common Usage

  •  Therapy for herpesviral infections (HSV and VZV) including encephalitis

  • Prophylaxis of herpesviral infections if recurrent disease or immunocompromised

Drug Monitoring

Drug Monitoring

Follow SCr, BUN, urine output as appropriate, liver enzymes and CBC.

Adverse Effects

Adverse Effects

  •  Nausea

  •  Vomiting

  • Diarrhea

  •  Headache

  • Phlebitis (IV)

  • Liver or renal dysfunction

  • Crystal nephropathy (keep patient well hydrated)

Major Interactions

Major Interactions
  •  May diminish efficacy of zoster or varicella vaccine.

Additional Information

Additional Information
  •  For oral indications, Valacyclovir is the pro-drug and is more bioavailable with more convenient dosing.

Pharmacology

Pharmacology

Antimicrobial class: Antiviral, nucleoside analogue

Average serum half life: Neonates: 4 hours
Children 1-12 years: 2-3 hours

Route of Elimination: Primarily kidney with 60-90% of drug excreted unchanged in the urine