From the Guidelines
Management of Varicella in Adults
Management of chickenpox in adults approximately 30 years of age involves antiviral therapy with acyclovir 800mg orally five times daily for 7-10 days, initiated within 24-48 hours of rash onset 1.
- Symptomatic relief with acetaminophen 650-1000mg orally every 4-6 hours as needed for fever and pain, and calamine lotion or oatmeal baths for pruritus may be recommended.
- In severe cases or those with compromised immune systems, hospitalization and intravenous acyclovir 10mg/kg every 8 hours may be necessary 1.
- It is essential to note that varicella disease is more severe and its complications more frequent among adolescents and adults 1, emphasizing the importance of prompt and effective management.
- For individuals with no history of varicella exposure, vaccination of household contacts can provide protection by decreasing the likelihood of introducing wild-type VZV into the household 1.
- The benefits of vaccinating susceptible household contacts of immunocompromised persons outweigh the extremely low potential risk for transmission of vaccine virus to immunocompromised contacts 1.
From the FDA Drug Label
Adults and Children over 40 kg: 800 mg 4 times daily for 5 days. The management of varicella (chicken pox) in adults approximately 30 years old is:
- Dose: 800 mg
- Frequency: 4 times daily
- Duration: 5 days Therapy should be initiated at the earliest sign or symptom of chickenpox 2.
From the Research
Management of Varicella in Adults
The management of varicella (chicken pox) in adults approximately 30 years old involves several approaches, including:
- Symptomatic treatment for immunocompetent patients with no signs of complications 3
- Antiviral therapy, such as aciclovir, to ameliorate symptoms and decrease the severity of chickenpox if administered early in the course of the infection 4, 5
- Passive immunisation with varicella zoster immunoglobulin (VZIG) to prevent or attenuate infection following exposure to varicella of an immunocompromised or pregnant individual or a neonate 5
- Active immunisation, which is universal in many developed countries 5
Treatment Options
Treatment options for chickenpox in adults include:
- Aciclovir, which can be initiated within 24 hours of onset of rash or later than 24 hours of onset of rash 4
- Antibiotics, such as Co-Amoxiclav or Ceftriaxone, which may be used in combination with antiviral drugs in some cases 3
- Corticosteroids, although their use remains a topic of debate 3
Special Considerations
Special considerations for the management of chickenpox in adults include:
- Immunocompromised individuals, who are at a higher risk of severe infection and may require intravenous acyclovir 5, 6
- Pregnant individuals, who may require passive immunisation with VZIG to prevent or attenuate infection 5
- Individuals with underlying diseases, who may require a different therapeutic approach depending on the severity of the clinical picture and the existence of underlying diseases 3