In the neonatal period, Zidovudine syrup 2 mg/kg orally four times a day is given for a period of?

HPSSC - 2015

Pharmacology

Easy

Appeared in: HPSSC - 2015

Explanation

The standard duration for Zidovudine (AZT) prophylaxis in neonates at risk of perinatal HIV transmission is 6 weeks.
This 6-week course is particularly recommended for infants classified as high-risk, which includes those born to mothers who did not receive antiretroviral therapy (ART) during pregnancy or had a high viral load.
Even in cases where a multi-drug regimen is used for high-risk infants, the Zidovudine component is continued for the full 6 weeks.
This duration is established to provide sufficient time for the drug to suppress any potential viral replication and prevent the establishment of chronic HIV infection in the newborn.

Option A: A 3-week course is shorter than the standard recommendation for comprehensive prophylaxis. While a 2-4 week regimen may be used for infants at very low risk, 6 weeks is the standard for high-risk or presumptive treatment.
Option B: An 8-week duration is longer than the standard initial prophylactic regimen for perinatal exposure.
Option C: A period of 6 days is critically insufficient for post-exposure prophylaxis and would not provide adequate protection against HIV.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology: Neonatal HIV Prophylaxis as background academic context rather than a clinical decision trigger.
A nurse's primary role is ensuring the correct administration of Zidovudine, including accurate weight-based dosing and strict adherence to the q6h schedule for the entire 6-week course.
Nurses must monitor the neonate for adverse effects of Zidovudine, most commonly hematologic toxicity. This involves observing for pallor, fatigue during feeding (signs of anemia), or signs of infection (neutropenia) and checking baseline and follow-up CBC results as ordered (typically at 4-8 weeks).
Patient and family education is crucial. The nurse must explain the importance of not missing doses to prevent treatment failure and ensure the family understands the follow-up testing schedule for the infant.

How to Approach the Question

First, identify the key components of the question: the drug (Zidovudine), the patient population (neonate), the context (prophylaxis), and the specific question (duration of treatment).
Recall or look up the standard guidelines for post-exposure prophylaxis (PEP) for infants born to HIV-positive mothers.
Recognize that treatment protocols often vary based on risk (low vs. high). The question asks for a general duration, so consider the most comprehensive or standard high-risk protocol, as this is a common examination point.
Evaluate the given options against the standard protocol. The standard duration for high-risk infants is 6 weeks.
Eliminate options that are clearly too short (6 days) or not standard (8 weeks). Differentiate between the low-risk (shorter) and high-risk (6 weeks) protocols to select the most appropriate answer.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 2120-2122