Herpes simplex virus (HSV) DNA polymerase (Pol) mutations can confer resistance to all currently available antiherpetic drugs. However, discrimination between mutations responsible for drug resistance and those that are part of viral polymorphism can be difficult with current methodologies. A new system is reported for rapid generation of recombinant HSV type 1 (HSV-1) DNA Pol mutants based on transfection of a set of overlapping viral cosmids and plasmids. With this approach, twenty HSV-1 recombinants with single or dual mutations within the DNA pol gene were successfully generated and subsequently evaluated for their susceptibilities to acyclovir (ACV), foscarnet (FOS), cidofovir (CDV), and adefovir (ADV). Mutations within DNA Pol conserved regions II (A719T and S724N), VI (L778M, D780N, and L782I), and I (F891C) were shown to induce cross-resistance to ACV, FOS, and ADV, with two of these mutations (S724N and L778M) also conferring significant reduction in CDV susceptibility. Mutant F891C was associated with the highest levels of resistance towards ACV and FOS and was strongly impaired in its replication capacity. One mutation (D907V) lying outside of the conserved regions was also associated with this ACV-, FOS-, and ADV-resistant phenotype. Some mutations (K522E and Y577H) within the ␦-region C were lethal, whereas others (P561S and V573M) induced no resistance to any of the drugs tested. Recombinants harboring mutations within conserved regions V (N961K) and VII (Y941H) were resistant to ACV but susceptible to FOS. Finally, mutations within conserved region III were associated with various susceptibility profiles. This new system allows a rapid and accurate evaluation of the functional role of various DNA Pol mutations, which should translate into improved management of drug-resistant HSV infections.Two categories of antivirals are available for the management of herpes simplex virus (HSV) infections. The first class of agents includes molecules that, following viral and/or cellular phosphorylation, compete with natural deoxynucleoside triphosphates for incorporation into the elongating viral DNA chain. Acyclovir (ACV) and penciclovir with their respective prodrugs, valacyclovir and famciclovir, are agents representative of this class and are considered the standard therapy for HSV infections. Although not indicated for the treatment of HSV infections, cidofovir [(S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine; CDV] and adefovir [9-(2-phosphonylmethoxyethyl)adenine; ADV] are acyclic nucleoside phosphonate derivatives that, once activated, are also alternative substrates for the viral DNA polymerase (Pol). The other class of HSV inhibitors consists of pyrophosphate analogues such as foscarnet (FOS). These agents are direct noncompetitive inhibitors of the viral DNA Pol. A single DNA Pol mutation could thus confer resistance to more than one antiviral depending on the specific drug binding site on the enzyme.Resistance to ACV, the most widely used anti-HSV agent, is due mainly to mutations in the viral t...