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تعداد آیتم قابل مشاهده باقیمانده : -35 مورد

Indications for antiviral therapy in persons with mpox*

Indications for antiviral therapy in persons with mpox*
Population Specific conditions
Patients who are severely immunocompromised (regardless of severity of mpox at time of presentation)
  • HIV with CD4 <200 cells/microL
  • Leukemia or lymphoma
  • Generalized malignancy
  • Solid organ transplantation
  • Therapy with alkylating agents within 180 days prior to mpox illness onset
  • Antimetabolites within 180 days prior to mpox illness onset
  • Radiation therapy within 180 days prior to mpox illness onset
  • Tumor necrosis factor inhibitors within 180 days prior to mpox illness onset
  • High-dose corticosteroids (equivalent of 20 mg or greater of prednisone for at least 14 days) within 90 days prior to mpox illness onset
  • Being a recipient with hematopoietic stem cell transplant <24 months post-transplant or ≥24 months but with graft-versus-host disease or disease relapse, or having autoimmune disease with immunodeficiency as a clinical component
  • Other comparable severe immunocompromising condition
Persons with active skin conditions placing the person at higher risk for disseminated infection
  • Eczema
  • Burns
  • Impetigo
  • Active varicella-zoster virus infection
  • Psoriasis
  • Darier disease (keratosis follicularis)
Pregnant or lactating individuals (regardless of severity of mpox at time of presentation)  
Persons <18 years of age (regardless of severity of mpox at time of presentation)  
Patients with protracted or life-threatening manifestations of mpox at presentation
  • Lesions affecting ≥25% of body surface that may be confluent, necrotic, and/or hemorrhagic in appearance or cause sepsis
  • Disease resulting in airway compromise or affecting the nervous system
  • Cardiac (eg, myocarditis) and/or neurologic disease (eg, encephalitis), which might occur in a small number of patients with mpox
  • Ocular or periorbital infection, regardless of the time since infection onset

In the United States, tecovirimat is an investigational agent and is not commercially available. These patient groups may meet criteria for the open label arm of the Study of Tecovirimat for Mpox (STOMP) Trial. They also meet criteria to receive the drug outside of a clinical trial though the CDC's Expanded access investigational new drug (EA-IND) protocol.

Clinicians can contact the CDC Clinical Consultation Team by email ([email protected]) or by phone (770-488-7100) for urgent clinical situations.
* Treatment can also be considered for immunocompetent patients with complications such as secondary bacterial infection, dehydration, or bronchopneumonia, as well as those with mpox infection at sites that are usually associated with severe pain or might result in sequelae such as scarring or strictures (eg, mouth, pharynx, anogenital area). For such patients, tecovirimat should be obtained through entry into a clinical trial, such as the STOMP trial, whenever possible.
Reference:
  1. Interim clinical guidance for the treatment of monkeypox. Centers for Diseae Control and Prevention. https://www.cdc.gov/poxvirus/mpox/clinicians/treatment.html (Accessed on June 18, 2024).

Adapted from: Tecovirimat (TPOXX) for treatment of mpox. Centers for Disease Control and Prevention. https://www.cdc.gov/poxvirus/mpox/clinicians/tecovirimat-ea-ind.html (Accessed on July 30, 2024).

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