Infectious disease pop quiz: Clinical challenge #11 for the ObGyn
Concise Q&As to hone your skills in infectious disease symptoms, diagnostic tests, and treatment in pregnant and nonpregnant women
In this question-and-answer series, our objective is to reinforce for the clinician several practical points of management for common infectious diseases. The principal references for the answers to the questions are 2 textbook chapters written by Dr. Duff.1,2 Other pertinent references are included in the text.
Obstetric patients with a history of recurrent herpes simplex infection should be treated with acyclovir 400 mg orally 3 times daily from 36 weeks until delivery. This regimen significantly reduces the likelihood of a recurrent outbreak near the time of delivery, which if it occurred, would necessitate a cesarean delivery. In patients at increased risk for preterm delivery, the prophylactic regimen should be started earlier.
Valacyclovir, 500 mg orally twice daily, is an acceptable alternative but is significantly more expensive.
