Page 207 - HPP ANTIMICROBIAL GUIDELINE 2018

Chicken pox

For passive PEP
Susceptible hosts include

• Immunocompromised children and adults who lack evidence of immunity to VZV
• New-borns of mothers with varicella shortly before or after delivery (i.e. 5 days before to 2 days after delivery)
• Premature infants born at ≥28 weeks of gestation who are exposed during their hospitalization and whose mothers do not have evidence of
immunity
• Premature infants born at <28 weeks of gestation or who weigh ≤1000 g at birth and were exposed during their hospitalization, regardless
of their mothers' evidence of immunity to varicella

Suggested Treatment
Infection/Condition Comments
Preferred Alternative

Chicken pox
Active Varicella vaccine:
Within 3-5 days of exposure for the susceptible healthy adult/child >1 month:
Clarithromycin 15 mg /kg /day PO
q12h for 7 days
Passive For patients who are at high risk for severe infection and
complications, and who are not candidates for the VZV vaccine Azithromycin 10mg/kg q24h for 5
days
Varicella zoster immune globulin 25iu/kg
(refer to product information)
OR

125iu/10kg (max 625iu) IM
OR
IVIG (400mg/kg)

As soon as possible after exposure up to10 days after

Patients receiving monthly high dose (≥400mg/kg) IVIG are likely
to be protected and probably do not require VariZIG if the most
recent dose of IVIG was administered ≤3 weeks before exposure

HPP AMG Chemoprophylaxis 98