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References

DOI: 10.1086/589747

Herpes simplex virus: acyclovir is recommended (A-I).

Acyclovir is the treatment of choice for patients with herpes simplex encephalitis.

The dosage of acyclovir in patients with normal renal function is 10 mg/kg intravenously every 8 h for 14–21 days.

Recently, the use of higher-dose acyclovir (20 mg/kg intravenously every 8 h for 21 days) in neonates with herpes simplex encephalitis has decreased mortality to 5%, with ≈40% of survivors developing normally.

A negative CSF PCR result at the end of therapy was associated with a better outcome, suggesting that another CSF specimen should be subjected to PCR for herpes simplex virus at the end of therapy in patients who have not had the appropriate clinical response; if the result is positive, antiviral therapy should be continued.

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