Spectrum: Local Antimicrobial Stewardship, for Prisma Health Children’s Hospital-Midlands

Acyclovir

C. diff Risk

None

Oral Bioavailability

NA

Approximate Cost

IV$$$ PO$

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Pediatric

Neonatal

Renal

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

General Information

Common Usage

Common Usage

Therapy for herpesviral infections (HSV and VZV) including encephalitis

Prophylaxis of herpes viral 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