Table 3.
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Indications and Preferred Antiviral Treatment of Herpes Simplex Virus Type Meningitis Among Respondents

Indicationno./No.(%)
What do you consider as indications for acyclovir or valacyclovir treatment of patients with confirmed HSV-2 meningitis?a
 I never or only rarely treat these patients with antiviralsb22/223(10)
 Severe symptoms76/223(34)
 No improvement in symptoms after 48 h of diagnosis27/223(12)
 Immunocompromising conditions84/223(38)
 Previous diagnosis of HSV-2 meningitis44/223(20)
 Concurrent HSV-2 ulcers (genital or oral)46/223(21)
 Patient indication (ie, patient requests antiviral treatment)11/223(5)
 I always treat these patients with antiviralsb88/223(39)
Favored antiviral regimen
 IV acyclovir followed by valacyclovir110/179(61)
 Monotherapy with IV acyclovir35/179(20)
 Monotherapy with valacyclovir34/179(19)
Duration of treatment (n = 174), d, median (IQR)7(7–10)
Preferred IV acyclovir dosages
 5 mg/kg 3 times daily8/145(6)
 10 mg/kg 3 times daily132/145(91)
 15 mg/kg 3 times daily5/145(3)
Preferred valacyclovir dosages
 1000 mg 3 times daily122/144(85)
 1000 mg 4 times daily3/144(2)
 2000 mg 3 times daily12/144(8)
 2000 mg 4 times daily2/144(1)
 Other5/144(3)
Adjunctive dexamethasone2/189(1)
Treat immunocompromised patients differently110/189c(58)
Indicationno./No.(%)
What do you consider as indications for acyclovir or valacyclovir treatment of patients with confirmed HSV-2 meningitis?a
 I never or only rarely treat these patients with antiviralsb22/223(10)
 Severe symptoms76/223(34)
 No improvement in symptoms after 48 h of diagnosis27/223(12)
 Immunocompromising conditions84/223(38)
 Previous diagnosis of HSV-2 meningitis44/223(20)
 Concurrent HSV-2 ulcers (genital or oral)46/223(21)
 Patient indication (ie, patient requests antiviral treatment)11/223(5)
 I always treat these patients with antiviralsb88/223(39)
Favored antiviral regimen
 IV acyclovir followed by valacyclovir110/179(61)
 Monotherapy with IV acyclovir35/179(20)
 Monotherapy with valacyclovir34/179(19)
Duration of treatment (n = 174), d, median (IQR)7(7–10)
Preferred IV acyclovir dosages
 5 mg/kg 3 times daily8/145(6)
 10 mg/kg 3 times daily132/145(91)
 15 mg/kg 3 times daily5/145(3)
Preferred valacyclovir dosages
 1000 mg 3 times daily122/144(85)
 1000 mg 4 times daily3/144(2)
 2000 mg 3 times daily12/144(8)
 2000 mg 4 times daily2/144(1)
 Other5/144(3)
Adjunctive dexamethasone2/189(1)
Treat immunocompromised patients differently110/189c(58)

Abbreviations: HSV-2, herpes simplex virus type 2; IQR, interquartile range; IV, intravenous.

a

Several choices possible.

b

Automatically excludes other answers.

c

Prolonged total duration of treatment (n = 36), prolonged IV acyclovir (n = 31), and always treat with antivirals (n = 25).

Table 3.
Open in new tab

Indications and Preferred Antiviral Treatment of Herpes Simplex Virus Type Meningitis Among Respondents

Indicationno./No.(%)
What do you consider as indications for acyclovir or valacyclovir treatment of patients with confirmed HSV-2 meningitis?a
 I never or only rarely treat these patients with antiviralsb22/223(10)
 Severe symptoms76/223(34)
 No improvement in symptoms after 48 h of diagnosis27/223(12)
 Immunocompromising conditions84/223(38)
 Previous diagnosis of HSV-2 meningitis44/223(20)
 Concurrent HSV-2 ulcers (genital or oral)46/223(21)
 Patient indication (ie, patient requests antiviral treatment)11/223(5)
 I always treat these patients with antiviralsb88/223(39)
Favored antiviral regimen
 IV acyclovir followed by valacyclovir110/179(61)
 Monotherapy with IV acyclovir35/179(20)
 Monotherapy with valacyclovir34/179(19)
Duration of treatment (n = 174), d, median (IQR)7(7–10)
Preferred IV acyclovir dosages
 5 mg/kg 3 times daily8/145(6)
 10 mg/kg 3 times daily132/145(91)
 15 mg/kg 3 times daily5/145(3)
Preferred valacyclovir dosages
 1000 mg 3 times daily122/144(85)
 1000 mg 4 times daily3/144(2)
 2000 mg 3 times daily12/144(8)
 2000 mg 4 times daily2/144(1)
 Other5/144(3)
Adjunctive dexamethasone2/189(1)
Treat immunocompromised patients differently110/189c(58)
Indicationno./No.(%)
What do you consider as indications for acyclovir or valacyclovir treatment of patients with confirmed HSV-2 meningitis?a
 I never or only rarely treat these patients with antiviralsb22/223(10)
 Severe symptoms76/223(34)
 No improvement in symptoms after 48 h of diagnosis27/223(12)
 Immunocompromising conditions84/223(38)
 Previous diagnosis of HSV-2 meningitis44/223(20)
 Concurrent HSV-2 ulcers (genital or oral)46/223(21)
 Patient indication (ie, patient requests antiviral treatment)11/223(5)
 I always treat these patients with antiviralsb88/223(39)
Favored antiviral regimen
 IV acyclovir followed by valacyclovir110/179(61)
 Monotherapy with IV acyclovir35/179(20)
 Monotherapy with valacyclovir34/179(19)
Duration of treatment (n = 174), d, median (IQR)7(7–10)
Preferred IV acyclovir dosages
 5 mg/kg 3 times daily8/145(6)
 10 mg/kg 3 times daily132/145(91)
 15 mg/kg 3 times daily5/145(3)
Preferred valacyclovir dosages
 1000 mg 3 times daily122/144(85)
 1000 mg 4 times daily3/144(2)
 2000 mg 3 times daily12/144(8)
 2000 mg 4 times daily2/144(1)
 Other5/144(3)
Adjunctive dexamethasone2/189(1)
Treat immunocompromised patients differently110/189c(58)

Abbreviations: HSV-2, herpes simplex virus type 2; IQR, interquartile range; IV, intravenous.

a

Several choices possible.

b

Automatically excludes other answers.

c

Prolonged total duration of treatment (n = 36), prolonged IV acyclovir (n = 31), and always treat with antivirals (n = 25).

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