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生殖器庖疹
首發
阿昔洛韋400mg，口服，每天3次，用7～10天；或
阿昔洛韋200mg，口服，每天5次，用7～10天；或
法昔洛韋250mg，口服，每天3次，用7～10天；或
纈昔洛韋 1.0g，口服，每天2次，用7～10天。
感染複發
間歇性治療
阿昔洛韋400mg，口服，每天3次，用5天；或
阿昔洛韋200mg，口服，每天5次，用5天；或
阿昔洛韋800mg，口服，每天2次，用5天；或
法昔洛韋125mg，口服，每天2次，用5天；或
纈昔洛韋500mg，口服，每天2次，用5天。
每日抑制性治療
阿昔洛韋400mg，口服，每天2次；或
法昔洛韋250mg，口服，每天2次；或
纈昔洛韋250mg，口服，每天2次；或
纈昔洛韋500mg，口服，每天1次；或
纈昔洛韋1000mg，口服，每天1次。
HSV嚴重感染 阿昔洛韋5～10mg/kg，靜脈注射，每8h 1次，用5～7天或至臨床癥狀
消失。
(來自中華醫學會-感染病學分會，美國CDC推薦的性傳播疾病治療指南，1998年)
If you are interested in English version (CDC STD Treatment Guidelines 2006),
please click below:
http://www.cdc.gov/std/treatment/
First Clinical Episode of Genital Herpes
Many persons with first-episode herpes have mild clinical manifestations
but later develop severe or prolonged symptoms. Therefore, patients with
initial genital herpes should receive antiviral therapy.
Recommended Regimens*
Acyclovir 400 mg orally three times a day for 7━10 days
OR
Acyclovir 200 mg orally five times a day for 7━10 days
OR
Famciclovir 250 mg orally three times a day for 7━10 days
OR
Valacyclovir 1 g orally twice a day for 7━10 days
* Treatment might be extended if healing is incomplete after 10 days of
therapy.
Established HSV-2 infection
The majority of patients with symptomatic, first-episode genital HSV-2 infection
subsequently experience recurrent episodes of genital lesions; recurrences
are less frequent after initial genital HSV-1 infection. Intermittent asymptomatic
shedding occurs in persons with genital HSV-2 infection, even in those with
longstanding or clinically silent infection. Antiviral therapy for recurrent
genital herpes can be administered either episodically to ameliorate or shorten
the duration of lesions or continuously as suppressive therapy to reduce
the frequency of recurrences. Many persons, including those with mild or
infrequent recurrent outbreaks, benefit from antiviral therapy; therefore,
options for treatment should be discussed. Some persons might prefer suppressive
therapy, which has the additional advantage of decreasing the risk of genital
HSV-2 transmission to susceptible partners (81).
Suppressive Therapy for Recurrent Genital Herpes
Suppressive therapy reduces the frequency of genital herpes recurrences
by 70%━80% in patients who have frequent recurrences (i.e., =6 recurrences
per year), and many patients report no symptomatic outbreaks. Treatment
also is effective in patients with less frequent recurrences. Safety and
efficacy have been documented among patients receiving daily therapy with
acyclovir for as long as 6 years and with valacyclovir or famciclovir for
1 year. Quality of life frequently is improved in patients with frequent
recurrences who receive suppressive therapy, compared with episodic treatment.
The frequency of recurrent genital herpes outbreaks diminishes over time
in many patients, and the patient』s psychological adjustment to the disease
might change. Therefore, periodically during suppressive treatment (e.g.,
once a year), providers should discuss the need to continue therapy with
the patient.
Daily treatment with valacyclovir 500 mg daily decreases the rate of HSV-2
transmission in discordant, heterosexual couples in which the source partner
has a history of genital HSV-2 infection (82). Such couples should be encouraged
to consider suppressive antiviral therapy as part of a strategy to prevent
transmission, in addition to consistent condom use and avoidance of sexual
activity during recurrences. Suppressive antiviral therapy probably reduces
transmission when used by persons who have multiple partners (including
MSM) and by those who are HSV-2 seropositive without a history of genital
herpes.
Recommended Regimens
Acyclovir 400 mg orally twice a day
OR
Famiciclovir 250 mg orally twice a day
OR
Valacyclovir 500 mg orally once a day
OR
Valacyclovir 1.0 g orally once a day
Valacyclovir 500 mg once a day might be less effective than other valacyclovir
or acyclovir dosing regimens in patients who have very frequent recurrences
(i.e., =10 episodes per year). Several studies have compared valacyclovir
or famciclovir with acyclovir. The results of these studies suggest that
valacyclovir and famciclovir are comparable to acyclovir in clinical outcome
(74,78,79,83). Ease of administration and cost also are important considerations
for prolonged treatment.
Episodic Therapy for Recurrent Genital Herpes
Effective episodic treatment of recurrent herpes requires initiation of
therapy within 1 day of lesion onset or during the prodrome that precedes
some outbreaks. The patient should be provided with a supply of drug or
a prescription for the medication with instructions to initiate treatment
immediately when symptoms begin.
Recommended Regimens
Acyclovir 400 mg orally three times a day for 5 days
OR
Acyclovir 800 mg orally twice a day for 5 days
OR
Acyclovir 800 mg orally three times a day for 2 days
OR
Famciclovir 125 mg orally twice daily for 5 days
OR
Famciclovir 1000 mg orally twice daily for 1 day
OR
Valacyclovir 500 mg orally twice a day for 3 days
OR
Valacyclovir 1.0 g orally once a day for 5 days
Severe Disease
Intravenous (IV) acyclovir therapy should be provided for patients who have
severe HSV disease or complications that necessitate hospitalization (e.g.,
disseminated infection, pneumonitis, or hepatitis) or CNS complications
(e.g., meningitis or encephalitis). The recommended regimen is acyclovir
5━10 mg/kg body weight IV every 8 hours for 2━7 days or until clinical
improvement is observed, followed by oral antiviral therapy to complete
at least 10 days of total therapy.
註：以上所有的葯都是處方葯，信息僅供參考! |
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