Helicobacter pylori - Portal Neonatal

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Infectious esophagitis
Table 3.4 Drugs for viral esophagitis
Drug Duration Dosage Remarks
Acyclovir 7–10 days 20mg/kg per dose orally four A nucleoside analog available for both oral and
times daily (80 mg/kg per day). intravenous administration. It is well tolerated;
Severe infections refractory to occasionally, rash, reversible renal failure or
normal oral dosages or in gastrointestinal symptoms occur. Dose
which the patient is unable adjustment should be made with renal
to swallow are treated with impairment. Risk of renal insufficiency is
i.v. acyclovir, 15–30 mg/kg per reduced with adequate prehydration
day in 3 divided doses
Ganciclovir 14–28 days 5 mg/kg given intravenously twice Drugs of first choice for the treatment of serious
per day systemic CMV infections. The need for
maintenance therapy of gastrointestinal CMV
infection remains unclear. Dosage reduction is
recommended in patients with renal
impairment. Main side-effects are: neutropenia,
thrombocytopenia, central nervous system
symptoms, abnormal liver function tests, fever
and rash. Simultaneous administration of G-
CSF or GM-CSF can prevent ganciclovirassociated
neutropenia
Foscarnet 14–28 days HSV infection: 40 mg/kg of body Second-line parenteral antiviral, reserved for
weight given either every 8 or treatment of HSV or CMV infections resistant to
every 12 h. This dose is injected conventional therapy. Main side-effects are:
slowly into a vein by an infusion nephrotoxicity, anemia, gastrointestinal
pump over at least 1 h. CMV toxicity, hyper- and hypocalcemia,
infection: 60 mg/kg, as above hypomagnesemia, hyper- and
hypophosphatemia, hypokalemia, seizures. It is
mainly used in the treatment of acyclovirresistant
HSV infections and ganciclovirresistant
CMV infections
Famciclovir 7 days In adults: 250 mg, three times Consider with acyclovir resistance, but limited
daily orally experience in infectious esophagitis. Use with
caution in subjects with renal insufficiency.
Main side-effects similar to those for acyclovir
Cidofovir 14 days 5 mg/kg i.v. once per week A novel monophosphate nucleotide analog
effective against CMV, HVS-1, HVS-2 and EBV.
Parenteral antiviral recently approved to treat
CMV retinitis. No reports on the treatment of
CMV esophagitis. Generally reserved for
patients with serious CMV disease for whom
ganciclovir and/or foscarnet therapy has failed.
Main side-effects are: nephrotoxicity,
proteinuria, glycosuria, neutropenia and
metabolic acidosis
CMV, cytomegalovirus; G, granulocyte; CSF, colony-stimulating factor; GM, granulocyte/macrophage; HSV, herpes
simplex virus; EBV, Epstein–Barr virus