This document summarizes management regimes for herpes simplex infections. It outlines symptomatic management with topical antivirals like docosanol cream or penciclovir cream. It then discusses the use of systemic antivirals like acyclovir, valacyclovir, and famciclovir to treat primary and recurrent infections of oral-facial, genital, and ocular herpes. These antivirals can be used for episodic treatment of outbreaks or daily suppression. It also provides guidance on treating neonatal herpes, eczema herpeticum, and herpes simplex encephalitis with intravenous acyclovir.

1. MANAGEMENT REGIMES FOR
HERPES SIMPLEX INF

2. SYMPTOMATIC MANAGEMENT
• Maintain Hygeine, Keep area dry and clean
• Treatment indicated in case of Persistence, Burning / Pain / Fever,
Superadded infection,
• TOPICALS
DOCOSANOL 10% CREAM LA 5 TIMES DAILY
X
07-10 DAYS
PENCICLOVIR 1% CREAM LA q 2 hrs
X
07-10 DAYS
ACYCLOVIR 5% CREAM LA 5 TIMES DAILY
X
07-10 DAYS
(Muco-adhesive Buccal Tablet (Sitavig 50mg) Single dose to Canine Fossa)

3. SYSTEMIC ANTIVIRALS
REDUCTION :
Healing time of lesions 16  12 days
07  05 days
Post-herpetic pain
07  05 days
04  02 days
Constitutional symp
06  03 days
04  03 days
No effect on Latency

4. ORO-FACIAL HERPES
PRIMARY INFECTION
T ACYCLOVIR 400 mg TDS X 07-10 days
T VALACYCLOVIR 1 g BD X 07-10 days
T FAMCICLOVIR 250 mg TDS X 07-10 days
ACYCLOVIR 15 mg/kg/dose 5 times a day x 07-10
days (Pediatric)
Also for Herpes Gladiatorum / Whitlow / Scrumpox

5. ORO-FACIAL HERPES
• RECURRENT : EPISODIC
T ACYCLOVIR 400 mg 5 times a day X 04-05 d
T VALACYCLOVIR 2 g BD X 01 d
T FAMCICLOVIR 500 mg TDS X 01 d

6. ORO-FACIAL HERPES
• RECURRENT : SUPPRESSION
T ACYCLOVIR 400 mg BD x 12 months

7. GENITAL HERPES (CDC-2010)
• PRIMARY INFECTION
T ACYCLOVIR 400 mg TDS X 07-10 days
T VALACYCLOVIR 1 g BD X 07-10 days
T FAMCICLOVIR 250 mg TDS X 07-10 days
Extended > 10 days if inadequate healing
ACYCLOVIR 15 mg/kg/dose 5 times a day x 07-10
days (Pediatric)

8. GENITAL HERPES
• RECURRENT : EPISODIC
T ACYCLOVIR 400 mg TDS X 05 d
T VALACYCLOVIR 1g OD X 05 d
T FAMCICLOVIR 125 mg BD X 05 d

9. GENITAL HERPES
• RECURRENT : SUPPRESSION
T ACYCLOVIR 400 mg BD X 12 months
T VALACYCLOVIR 500 mg BD X 12 months
T FAMCICLOVIR 250 mg TDS X 12 months

10. GENITAL HERPES
• RECURRENT : SUPPRESSION in PREGNANCY
T ACYCLOVIR 400 mg TDS
36th Week of Gestation till Delivery

11. OCULAR HERPES
• PRIMARY INFECTION
T ACYCLOVIR 400 mg 5 times a day
T VALACYCLOVIR 1 gm BD
Topical 1 % ED TRIFLURIDINE, 0.1 % ED
IDOXURIDINE or 0.5 % Ointment, 3 % Ointment
VIDARABINE q 2 hrs Day + q 4 hrs Night

12. OCULAR HERPES
• RECURRENCE : SUPPRESSION
T ACYCLOVIR 400 mg TDS X 12 months

13. NEONATAL HERPES
• Inj ACYCLOVIR
20 mg/kg/dose TDS
x 02 – 03 weeks
(Max 80 mg/kg/day)

14. ECZEMA HERPETICUM
T ACYCLOVIR 400 mg TDS X 14-21 days
T VALACYCLOVIR 1 g BD X 14-21 days
T FAMCICLOVIR 250 mg TDS X 14-21 days
Inj ACYCLOVIR 10-15 mg/kg/dose TDS X 02 -03
weeks

15. HERPES SIMPLEX ENCEPHALITIS
• Inj ACYCLOVIR IV
10-15 mg/kg/dose TDS
X 14-21 days
Also for Disseminated Herpes Simplex Inf

16. THANK YOU