Viral meningitis (including HSV and VZV) is commonly a self-limiting illness.
Antiviral treatment should be used where there are clinical features of encephalitis or in systemically unwell immunocompromised patient (i.e. possible viraemia)
Consider covering for bacterial meningo-encephalitis too where there are other clinical features that could suggest bacterial infection e.g. haemodynamically unstable, high peripheral blood WCC and/or CRP
Aciclovir 10mg/kg IV 8 hourly
IV route necessary to ensure adequate tissue levels
Adjust dose in renal impairment - d/w pharmacy for advice if needed
If BMI >30 Use adjusted body weight
If no weight available dose based on ideal body weight
AdjBW = (0.4 x (TBW – IBW)) + IBW
(IBW; ideal body weight, TBW; total body weight)
Ideal body weight table here
Antimicrobial prescribing: NHS Forth Valley