Which antiviral medication is used to treat neonatal herpes simplex virus infections?

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Multiple Choice

Which antiviral medication is used to treat neonatal herpes simplex virus infections?

Explanation:
In neonatal HSV infections, the goal is to rapidly suppress HSV replication with an antiviral that reaches infected tissues, including the brain, when the disease involves the CNS or disseminates. Acyclovir fits this need best because it is activated inside HSV-infected cells by viral thymidine kinase to a monophosphate form, then by cellular enzymes to the triphosphate form, which inhibits viral DNA polymerase and causes chain termination. This targeted mechanism, combined with proven safety and efficacy in newborns, makes it the treatment of choice for neonatal HSV. Ganciclovir, while effective against CMV, has more bone marrow toxicity and is not the preferred option for HSV. Foscarnet can be used for acyclovir-resistant HSV or certain CMV cases, but its nephrotoxicity and broader toxicity profile make it a less favorable first-line choice in neonates. Zidovudine (AZT) targets HIV, not HSV, so it has no role in treating neonatal HSV infections.

In neonatal HSV infections, the goal is to rapidly suppress HSV replication with an antiviral that reaches infected tissues, including the brain, when the disease involves the CNS or disseminates. Acyclovir fits this need best because it is activated inside HSV-infected cells by viral thymidine kinase to a monophosphate form, then by cellular enzymes to the triphosphate form, which inhibits viral DNA polymerase and causes chain termination. This targeted mechanism, combined with proven safety and efficacy in newborns, makes it the treatment of choice for neonatal HSV.

Ganciclovir, while effective against CMV, has more bone marrow toxicity and is not the preferred option for HSV. Foscarnet can be used for acyclovir-resistant HSV or certain CMV cases, but its nephrotoxicity and broader toxicity profile make it a less favorable first-line choice in neonates. Zidovudine (AZT) targets HIV, not HSV, so it has no role in treating neonatal HSV infections.

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