Paediatric
Infected eczema (Herpeticum)
- Treat for 5 days.
- Also prescribe emollient and topical steroids of appropriate potency (see OUH dermatology guideline). Eczema is often undertreated due to use of inappropriately low potency corticosteroids. Topical steroids are required to reduce inflammation especially if secondary infection is suspected.
- Patients require isolation until MRSA swab results available. Use standard infection control measures
- Consider also prescribing antibiotics as secondary bacterial infection is common Infected eczema (Bacterial, mild-moderate) and Infected eczema (Bacterial, severe)
- Take bacterial and viral swabs (for HSV, VZV) prior to starting treatment.
- Consult Paediatric ID and Dermatology if necessary. If eczema herpeticum involves the skin around the eyes, the child should be referred for same-day ophthalmological and dermatological advice.
Preferred
1 month - 11 years: aciclovir po (see oral dosing table) or iv (see iv dosing table). For immunocompromised patients refer to BNFc for aciclovir dosing
12 years and over: valaciclovir po 500mg BD or aciclovir iv (see iv dosing table). For immunocompromised patients refer to BNFc for aciclovir dosing
Aciclovir ORAL dosing table
(NOTE: For immunocompromised patients refer to BNFc for aciclovir dosing)
| Age | aciclovir ORAL dose |
| 1-23 months | 100 mg 5 times a day |
| 2-11 years | 200 mg 5 times a day |
NOTE: For patients 12 years and over, valaciclovir is the first line oral agent, see above for dosing.
Aciclovir IV dosing table
(NOTE: For immunocompromised patients refer to BNFc for aciclovir dosing)
|
Age |
aciclovir IV dose |
|
Under 3 months |
20mg/kg TDS and discuss with paediatric ID |
|
3 months - 11 years |
250mg/m2 TDS |
|
12-17 years |
5mg/kg TDS |