Evid Based Med 18:e20 doi:10.1136/eb-2012-100674
  • Online articles
  • Cohort study

Delayed acyclovir therapy in neonates with herpes simplex virus infection is associated with an increased odds of death compared with early therapy

  1. Sarah S Long
  1. Section of Infectious Diseases, St Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA
  1. Correspondence to : Sarah S Long
    Section of Infectious Diseases, St Christopher's Hospital for Children, 3601 A Street, Philadelphia, PA 19134, USA; sarah.long{at}

Commentary on:


High-dose acyclovir therapy substantially reduces death and improves neurological outcome from neonatal herpes simplex virus (HSV) infection.1 The effect of time of initiation of therapy on outcomes is not known precisely. Shah and colleagues sought to determine whether delayed acyclovir therapy after hospitalisation was associated with death among neonates with HSV infection.


In this retrospective, multicentre observational study, data were obtained from the Paediatric Health Information System (PHIS), a US national database containing resource-utilisation data during hospitalisation in 41 freestanding, tertiary care children's hospitals from 2003 through 2009. Infants ≤28 days of age with a discharge diagnosis of HSV infection were studied. The primary exposure of interest was early acyclovir administration (given …

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