Varicella (Chickenpox) Organism-Specific Therapy
No Results
No Results
processing….
Treatment regimens for varicella-zoster virus (VZV) are provided below, including those for acyclovir, varicella virus vaccine live (Varivax), and varicella-zoster immune globulin (VariZIG).
Adults with encephalitis, pneumonia, or immunocompromised patients [1] :
Acyclovir 10 mg/kg IV q8h for 7-10 days
Adults and children >12 years at increased risk for complications:
Acyclovir 800 mg PO 5 times daily x 5-7 days
Valacyclovir 20 mg/kg PO 3 times daily for 5 days; not to exceed 1 g/dose 3 times daily
Children >1 year who have encephalitis or pneumonia or are immunocompromised:
Acyclovir 500 mg/m2 IV q8h for 7-10 days
Children 2-12 years who are at increased risk for complications:
Acyclovir 20 mg/kg PO 4 times daily for 5 days; not to exceed 3200 mg/day
Valacyclovir 20 mg/kg PO 3 times daily for 5 days; not to exceed 1 g/dose 3 times daily
Children < 1 year who are immunocompromised:
30 mg/kg/day IV in 3 divided doses for 7-10 days
Children 2-12 years with uncomplicated varicella:
Use of acyclovir is not routinely recommended
Acyclovir use does not affect incidence of pruritus, complications, or secondary transmission in children with varicella
Consider acyclovir use in secondary household cases, in which the disease is usually more severe
Varicella virus vaccine live(Varivax)
Used for vaccination against varicella in individuals 1 y and older. [1]
Children 1-12 years:
Administer first dose of 0.5 mL subcutaneously at age 12-15 mo
Second dose is routinely administered at age 4-6 y; second dose can be given at any age as long as it has been at least 3mo since first dose
Adults and children 13 years and older with no evidence of immunity [1] :
Administer 2 doses of 0.5 mL subcutaneously 4-8wk apart
Varicella-zoster immune globulin(VZIG) post exposure
Varicella zoster immune globulin (VariZIG by Cangene) is indicated for administration to high-risk individuals within 10 days (ideally within 4 days) of chickenpox (varicella zoster virus) exposure. If VariZIG is unavailable, intravenous immunoglobulin (IVIG) can be used.
High-risk groups include the following:
Immunocompromised children and adults
Newborns of mothers with varicella shortly before or after delivery
Premature infants
Infants less than one year of age
Adults without evidence of immunity
Pregnant women
VZIG is indicated in pregnant women for the prevention or reduction in severity of maternal infection within 10 days (ideally within 96 hours of exposure to VZV). [2]
VZIG should be given to an infant if the mother develops varicella from 5 days before to 2 days after delivery
VZIG should be given to hospitalized premature infants of ≥28 wk gestation whose mothers have no history of varicella infection; also, VZIG should be given to hospitalized premature infants < 28 wk gestation or weighing ≤1000 g at birth regardless of maternal history when a significant exposure has occurred
Recommended dose is 125 IU/10 kg body weight, as follows:
< 2 kg: 62.5 IU I
2.1-10 kg: 125 IU IM
10.1-20 kg: 250 IU IM
20.1-30 kg: 375 IU IM
30.1-40 kg: 500 IU IM
Children >40 kg and adults: 625 IU IM
Marin M, Guris D, Chaves SS, Schmid S, Seward JF. Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007 Jun 22. 56:1-40. [Medline].
Centers for Disease Control and Prevention (CDC). Updated recommendations for use of VariZIG – United States, 2013. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6228a4.htm?s_cid=mm6228a4_w. Accessed: July 23, 2013.
American Academy of Pediatrics. Pickering LK, ed. Red Book: 2012 Report of the Committee on Infectious Diseases. 29th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2012.
Richard Lichenstein, MD Professor, Pediatric Emergency Department, University of Maryland School of Medicine
Richard Lichenstein, MD is a member of the following medical societies: American Medical Association, American Academy of Pediatrics
Disclosure: Nothing to disclose.
Jasmeet Anand, PharmD, RPh Adjunct Instructor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London
Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.
Thomas E Herchline, MD Professor of Medicine, Wright State University, Boonshoft School of Medicine; Medical Consultant, Public Health, Dayton and Montgomery County (Ohio) Tuberculosis Clinic
Thomas E Herchline, MD is a member of the following medical societies: Alpha Omega Alpha, Infectious Diseases Society of America, Infectious Diseases Society of Ohio
Disclosure: Nothing to disclose.
Varicella (Chickenpox) Organism-Specific Therapy
Research & References of Varicella (Chickenpox) Organism-Specific Therapy |A&C Accounting And Tax Services
Source
0 Comments