For HZO keratitis, what is an appropriate oral antiviral regimen for the first week?

For HZO keratitis, what is an appropriate oral antiviral regimen for the first week?

• A. Acyclovir 800 mg 5x/day for 1 week
• B. Valacyclovir 1 g twice daily for 1 week
• C. Famciclovir 500 mg twice daily for 1 week
• D. Acyclovir 400 mg five times daily for 7 days

Answer: (A)

In herpes zoster ophthalmicus, starting systemic antiviral therapy promptly is essential to suppress viral replication in ocular tissues and reduce complications. The recommended first-week regimen is high-dose acyclovir: 800 mg taken five times daily for about seven days. This dosing achieves the necessary plasma and tissue exposure to effectively inhibit VZV during the acute phase and helps limit keratitis, uveitis, and other ocular involvement. The other regimens either underdose (making treatment less effective for VZV in the eye) or dose too infrequently for this indication, which is why they’re not appropriate for the first week.

In herpes zoster ophthalmicus, starting systemic antiviral therapy promptly is essential to suppress viral replication in ocular tissues and reduce complications. The recommended first-week regimen is high-dose acyclovir: 800 mg taken five times daily for about seven days. This dosing achieves the necessary plasma and tissue exposure to effectively inhibit VZV during the acute phase and helps limit keratitis, uveitis, and other ocular involvement. The other regimens either underdose (making treatment less effective for VZV in the eye) or dose too infrequently for this indication, which is why they’re not appropriate for the first week.