Persistent Gaps in Appropriate Use of Empiric Acyclovir in Neonates

The use of empiric acyclovir for suspected neonatal herpes simplex virus (HSV) infection has been debated for years. To identify the gap in the decision to initiate empiric acyclovir, we performed a retrospective chart review and administered a survey to pediatricians to assess current practices reg...

Full description

Saved in:
Bibliographic Details
Published in:Clinical pediatrics 2017-05, Vol.56 (5), p.472-479
Main Authors: Wilson, Peyton, Sutton, Ashley G., Nassef, Christopher, Falato, Christopher, Jhaveri, Ravi
Format: Article
Language:English
Subjects:
Acyclovir
Acyclovir - therapeutic use
Antiviral drugs
Evaluation
Herpes simplex
Herpes Simplex - drug therapy
Humans
Infant
Infant, Newborn
Infant, Newborn, Diseases - drug therapy
Infants
Infections
Male
Neonates
Newborn babies
Pediatrics
Prospective Studies
Quality control
Retrospective Studies
Risk groups
Uncertainty
Viral infections
Viruses
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The use of empiric acyclovir for suspected neonatal herpes simplex virus (HSV) infection has been debated for years. To identify the gap in the decision to initiate empiric acyclovir, we performed a retrospective chart review and administered a survey to pediatricians to assess current practices regarding evaluation for possible HSV infection. Seventy infants received empiric acyclovir over a 1-year period; of these, 3 infants (4.3%) had positive HSV testing. Fourteen infants were identified as “high-risk” for HSV infection; of these, 13 infants had incomplete testing. Survey results revealed uncertainty in the decision to initiate acyclovir and in the composition of complete diagnostic testing. This study confirmed the clinical uncertainty in the decision to initiate empiric acyclovir. Using this chart review and survey as a baseline, future efforts will focus on a quality improvement project to reduce empiric acyclovir use in low-risk infants and to ensure complete diagnostic evaluation in high-risk infants.
ISSN:0009-9228
1938-2707
DOI:10.1177/0009922816678975