Is Prophylaxis Against CMV Reactivation Useful in Critically Ill Immunocompetent Patients?

Cytomegalovirus can be effectively suppressed in such patients, and valganciclovir may be a better choice than high dose valacyclovir.

Most adults are latently infected with cytomegalovirus (CMV); reactivation occurs in up to 42% of critically ill seropositive immunocompetent adults (Crit Care Med 2009; 37:2350). Multiple studies demonstrate an association between CMV reactivation and increased morbidity and mortality.

In this single-center study, the authors attempted to determine the safety and efficacy of antiviral prophylaxis in seropositive intensive care unit (ICU) patients requiring prolonged mechanical ventilation. Subjects were randomized to high-dose valacyclovir (2 g every 6 hours), low-dose valganciclovir (450 mg daily), or standard care. Quantitative polymerase chain reaction (PCR) testing was performed periodically on plasma, urine, throat swab, and pulmonary …

Reviewing Author

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Is Prophylaxis Against CMV Reactivation Useful in Critically Ill Immunocompetent Patients?

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Reviewing Author