Which medications in the drug class Antivirals are used in the treatment of Encephalitis?

Updated: Aug 07, 2018
  • Author: David S Howes, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Antivirals

The goal of the use of antivirals for herpes simplex encephalitis (HSE) and varicella-zoster encephalitis is to shorten the clinical course, prevent complications, prevent the development of latency and/or subsequent recurrences, decrease transmission, and eliminate established latency.

Acyclovir (Zovirax)

Acyclovir has demonstrated inhibitory activity directed against both herpes simplex virus type 1 (HSV-1) and HSV-2, and infected cells selectively take it up.

Foscarnet (Foscavir)

Foscarnet is an organic analogue of inorganic pyrophosphate. It inhibits replication of known herpes viruses, including cytomegalovirus, CMV, HSV-1, and HSV-2. It exerts antiviral activity by inhibiting viral replication at pyrophosphate-binding sites on virus-specific DNA polymerases at concentrations that do not affect cellular DNA polymerases.

Patients who have poor clinical response or experience persistent viral excretion during therapy, especially HIV-positive patients, may be resistant to acyclovir. Patients who tolerate foscarnet may benefit from maintenance-level administration of 120 mg/kg/d early in treatment. Dosing should be individualized on the basis of the patient's renal function.


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