Adult Outpatients: Skin and Soft-Tissue Infections: Herpes Zoster Infections

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Doses provided in this table are for patients with normal renal and hepatic function. Click on drug link to go to dosing guidelines.  Some antimicrobials are restricted (ID-R).  Click on link for guidelines on obtaining authorization.

Diagnosis

Common Pathogens

Drug(s) of First Choice

Comments

Immunocompetent

(Shingles/Zoster)

 

Immunocompromised

(Lymphoma, HIV infection, etc) and not severe (one dermatome) 

Varicella-Zoster Virus

Acyclovir 800 mg PO 5x/day x 7-10 days

OR

Valacyclovir 1 g PO TID x 7 days

Treatment effective only if initiated within 48-72 hours of onset of lesions. May shorten duration of illness in immunocompetent patients.

 

In patients > 65 years old administration of concomitant corticosteroids may improve quality of life. 

Primary Infection in Adults (Chicken Pox) 

Varicella-Zoster Virus

Acyclovir 800 mg PO 5x/day x 5 days

OR

Valacyclovir 1 g PO TID x 5 days

Initiate therapy within 24 hours of onset of rash.

 

Vaccination of non-immune close contacts recommended. Acyclovir treatment may also be effective for prophylaxis of at-risk individuals.