Chickenpox: Temperature Not Settling After Antiviral Therapy

Clinical Scenario

A patient with chickenpox has been admitted and treated with antiviral therapy, including intravenous aciclovir, with the primary goal of settling temperature. Temperature has not settled as expected on that regimen.

Previous Treatment — Failure Condition

Prior antiviral therapy (intravenous aciclovir, with planned oral antiviral step-down) did not achieve its key target: settling of temperature. This protocol describes the next clinical step triggered by that failure.

Next-Step Approach (Partial — Full Regimen via CTA)

Persistent or renewed fever in this setting raises suspicion of secondary bacterial infection. The next step involves adding an appropriate antibiotic — the specific agent, selection criteria, and complete regimen are detailed in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

A significant rise in temperature 2 or 3 days into the illness may indicate a secondary bacterial infection and treatment with appropriate antibiotics, such as flucloxacillin, co-amoxiclav or a macrolide should be considered.

DOI: 10.1016/j.jinf.2008.03.004

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