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Aciclovir Renal Dosing — SCE Infectious Diseases MCQ

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HardImmunocompromised HostAciclovir Renal DosingSCE Infectious Diseases

A renal-transplant recipient has localised thoracic zoster without visceral or neurological features. Cockcroft–Gault creatinine clearance is 35 mL/min and oral treatment is selected after specialist review. What renal adjustment is required to the standard oral aciclovir zoster regimen?

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Correct answer: B — Continue aciclovir 800 mg five times daily

For oral zoster treatment the SmPC reduces aciclovir to 800 mg three times daily at creatinine clearance 10–25 mL/min and twice daily below 10 mL/min. At 35 mL/min no frequency reduction is specified, although hydration, renal function and neurotoxicity require close review. Dose adjustment should use creatinine clearance, not an unqualified eGFR.

Reference: Aciclovir SmPC: https://www.medicines.org.uk/emc/product/4336/smpc