University of Wisconsin–Madison Medical College of Wisconsin

Valacyclovir Versus Acyclovir for Herpes Simplex Virus Suppression Following Neonatal Infection

Haley A. Olkiewicz, PharmD; Michelle L. Mitchell, MD; Katie M. Ray, PharmD; Evelyn M. Kuhn, PhD; Tracy N. Zembles, PharmD

WMJ. 2024;123(6):589-592.

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ABSTRACT

Background: Anecdotal experience suggests efficacious valacyclovir use for neonatal herpes simplex virus (HSV) suppression, with limited published literature. The objective of this study was to evaluate HSV recurrence rates between valacyclovir and acyclovir for suppression of HSV following neonatal infection.

Methods: We conducted a single center, retrospective cohort analysis of patients less than 6 weeks old with a positive HSV polymerase chain reaction who received oral acyclovir or valacyclovir. Demographics, dosing, and recurrence rates were analyzed.

Results: Six patients received acyclovir and 13 received valacyclovir. The recurrence rate was similar in both groups.

Discussion: Valacyclovir may be an alternative to acyclovir for suppression of neonatal HSV, offering less frequent dosing and increased compliance. Larger studies are needed to confirm valacyclovir efficacy for neonatal HSV suppression.


Author Affiliations: Children’s Wisconsin, Milwaukee, Wisconsin (Olkiewicz, Ray, Kuhn, Zembles); Medical College of Wisconsin, Milwaukee, Wisconsin (Mitchell).
Corresponding Author: Haley Olkiewicz, PharmD, 8915 W Connell Ct, Milwaukee, WI 53226; email holkiewicz@childrenswi.org; ORCID ID 0000-0003-1932-4673
Funding/Support: None declared.
Financial Disclosures: None declared.
Acknowledgments: The authors wish to acknowledge Sue Kehl, PhD, and Ross Hellenbrand for their contributions to data report creation.
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