Continuous Intravenous Acyclovir as Outpatient Parenteral Antimicrobial Therapy for HSV and VZV Neurological Infections: A Case Series With Pharmacokinetic and Cost Evaluation, and Review of Literature.
Irene G Manders, Eline L van Tuinen, Martijn Weisfelt et al.
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Case in brief
This case series involved eight patients with neurological infections caused by HSV or VZV who transitioned to continuous intravenous acyclovir via an outpatient parenteral antimicrobial therapy (OPAT) program after initial hospitalization. All patients achieved good clinical responses, with no persistent complications noted, although one patient experienced persistent ptosis and another developed postherpetic neuralgia. Acyclovir plasma concentrations remained above therapeutic levels, and the program resulted in significant cost savings.
Diagnostic / clinical pearl
Continuous intravenous acyclovir can be effectively administered in an outpatient setting for HSV and VZV neurological infections, maintaining therapeutic drug levels and improving patient comfort.
Why it matters
This approach not only enhances patient comfort but also reduces healthcare costs and hospital resource utilization, highlighting the potential for outpatient management of viral neurological infections.