Antiviral Therapy in Children

Introduction to Acyclovir Use

The American Academy of Pediatrics (AAP) states that administration of acyclovir to healthy children does not have sufficient clinical benefit to justify its routine use, particularly in those under 2 years of age due to limited safety and pharmacokinetic data 1
For most immunocompetent children with uncomplicated herpes infections, the clinical benefits of oral acyclovir do not outweigh the potential risks, as per the AAP guidelines 1

Prophylaxis of initial episodes of HSV disease is not recommended in children, according to multiple guidelines 2, 3, 4
For prevention of chickenpox, varicella zoster immune globulin (VZIG) is recommended within 96 hours of exposure rather than acyclovir, especially in VZV-susceptible children 3, 4
Varicella vaccine is recommended for HIV-infected children who are asymptomatic and not immunosuppressed at 12-15 months of age, highlighting the importance of vaccination over antiviral prophylaxis 3, 4

Vaccination remains the preferred method for prevention in susceptible children, as stated by the American Academy of Pediatrics 1

No specific pharmacokinetic facts are mentioned with a citation id, however, the article emphasizes significant pharmacokinetic differences in infants under 3 months.