For an infant on suppressive oral acyclovir after neonatal herpes treatment, what is the recommended action if neutropenia occurs?

For an infant on suppressive oral acyclovir after neonatal herpes treatment, what is the recommended action if neutropenia occurs?

• A. Continue acyclovir at the same dose
• B. Temporarily discontinue acyclovir until neutrophil count recovers
• C. Switch to intravenous acyclovir
• D. Stop therapy immediately with no monitoring

Answer: (B)

Neutropenia means the newborn’s bone marrow isn’t producing enough neutrophils, which raises the risk of serious infection, especially in infancy. If neutropenia occurs while on suppressive oral acyclovir for neonatal herpes, the safest step is to temporarily stop the drug and monitor the neutrophil count until it returns to normal. This pause lets the bone marrow recover and reduces infection risk. After recovery is documented, you can reassess therapy—often restarting at a lower dose or with guidance from the treating team. Continuing the same dose would keep worsening the neutropenia, switching to intravenous therapy doesn’t resolve the underlying issue, and stopping without monitoring could miss recovery or relapse.

Neutropenia means the newborn’s bone marrow isn’t producing enough neutrophils, which raises the risk of serious infection, especially in infancy. If neutropenia occurs while on suppressive oral acyclovir for neonatal herpes, the safest step is to temporarily stop the drug and monitor the neutrophil count until it returns to normal. This pause lets the bone marrow recover and reduces infection risk. After recovery is documented, you can reassess therapy—often restarting at a lower dose or with guidance from the treating team. Continuing the same dose would keep worsening the neutropenia, switching to intravenous therapy doesn’t resolve the underlying issue, and stopping without monitoring could miss recovery or relapse.