Anogenital Herpes

Antimicrobial prescribing: NHS Lothian
NHS Lothian

Confirm the diagnosis by de-roofing a vesicle with swab and sending it in viral transport medium (the same swab type as a viral throat swab) for HSV PCR

  • On TRAK you can use "Swab - vesicular rash" and change the site of the swab to the correct body location and in the information indicate your clinical concern.

Antibiotic Recommendation

Aciclovir 200mg 5 times per day, for 5 days

OR

Aciclovir 400mg every 8 hours, for 5 days

In very severe cases review at 5 days and continue therapy for a further 5 days, if lesions have not resolved.
In a person living with HIV or other form of immunosuppression: Aciclovir 400mg five times daily for 10 days or Valaciclovir 1g 12 hourly for 10 days

Patient initiated episodic treatment of recurrent infection

Aciclovir 800mg 8 hourly for 2 days

OR

Aciclovir 400mg 8 hourly for 3 days

Suppressive therapy

Recommendation

Aciclovir   400mg 12 hourly

Alternative

Aciclovir  200mg 6 hourly

OR

Valaciclovir 500mg once daily (discuss with consultant)

Notes

Likely organisms: Herpes simplex viruses (HSV) HSV-1 and HSV-2