Acyclovir treatment of varicella in otherwise healthy children

Balfour, Henry H.; Kelly, Joan; Suarez, Carmen S.; Heussner, Ralph C.; Englund, Janet A.; Crane, Deborah D.; McGuirt, Paul V.; Clemmer, Anne F.; Aeppli, Dorothee M.

doi:10.1016/s0022-3476(05)81618-x

Cited by 172 publications

(68 citation statements)

References 13 publications

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“…If treat ment was initiated within 24 h after the lesions appeared, aciclovir decreased time to healing of lesions (by 1-2 days), the total number of lesions (by 6-46%) and dura tion of fever (by 0.5-1 day). The rate of complications of varicella in otherwise healthy children was not signifi cantly reduced by aciclovir therapy [72]. Therefore, oral aciclovir therapy cannot be recommended routinely for the treatment of uncomplicated varicella in otherwise healthy children [76], However, in children at increased risk of severe varicella due to concurrent cutaneous or pulmonary disorders and individuals 13 years of age or older, antiviral treatment should be considered if it can be initiated within 24 h after the onset of rash [76].…”

Section: Varicellamentioning

confidence: 92%

“…In otherwise healthy children, adolescents and adults with varicella oral aciclovir therapy has been employed with only marginal therapeutic effect [72][73][74][75]. If treat ment was initiated within 24 h after the lesions appeared, aciclovir decreased time to healing of lesions (by 1-2 days), the total number of lesions (by 6-46%) and dura tion of fever (by 0.5-1 day).…”

Section: Varicellamentioning

confidence: 99%

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Antiviral Therapy of Herpes simplex and Varicella-zoster Virus Infections

Wutzler¹

1997

Intervirology

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Antiviral treatment of herpesvirus infections is rapidly changing since the advent of new drugs with improved oral availability. The efficacy of valaciclovir, the prodrug of aciclovir, and famciclovir, the prodrug of penciclovir, in the treatment of herpes genitalis and acute herpes zoster has been well documented in large clinical trials. Both drugs are effective on zoster-associated pain. Brivudin and sorivudine which are the most active compounds against varicella-zoster virus (VZV) in cell culture have also been successful in the treatment of herpes zoster. Aciclovir is still the standard therapy of severe herpes simplex virus (HSV) and varicella virus infections. In patients treated with aciclovir, the mortality of herpes encephalitis has been reduced to about 25%. The development of resistance against aciclovir and the other nucleoside analogues has not been a problem to date in the treatment of immunocompetent individuals. However, in immunocompromised patients, aciclovir-resistant HSV strains often emerge. In such cases, intravenous foscarnet is the current treatment of choice.

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Section: Varicellamentioning

confidence: 92%

Section: Varicellamentioning

confidence: 99%

Antiviral Therapy of Herpes simplex and Varicella-zoster Virus Infections

Wutzler¹

1997

Intervirology

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“…Placebo-controlled trials of acyclovir have shown that new lesion formation and the rate of lesion healing can be improved (Balfour et et., 1990(Balfour et et., , 1992Dunkle et al, 1991;Wallace et al, 1992). Insufficient cases of complications were observed to provide definitive data, but the reduction in the proportion of individuals with active vesicle formation after day 3 of treatment is encouraging.…”

Section: Varicella Zoster Virusmentioning

confidence: 99%

Progress in the Clinical Management of Herpesvirus Infections

Griffiths

1995

Antivir Chem Chemother

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SummaryAntiviral drug discovery has produced a series of drugs active against herpesviruses in vitro. Several of these are now licensed and/or have been used in clinical practice. This article reviews the mechanisms· of action of acyclovir, ganciclovir, penciclovir, sorivudine and foscarnet, the development of resistance to these drugs and their pharmacokinetic and cellular toxicities. Based upon the natural histories of HSV, VZV and CMV, treatment objectives for each virus are discussed and the performance of each drug matched against these objectives. Overall, it is concluded that the perfect drug for treating herpesviruses does not exist, but that significant progress has been made towards controlling several herpesvirus diseases. It.is suggested that further progress will require not just improved drug discovery programmes, but also an understanding of different pathogeneses and an appreciation by practising physicians that antiviral drugs must be given early in the infectious process to achieve the best results.

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“…Of importance, oral acyclovir decreases the frequency of eye complications in patients with ophthalmic zoster (69,70). In one study of otherwise healthy children with chickenpox, oral acyclovir reduced the duration of disease by 1 day but did not influence the complication rate, days off from school, or transmission rate within the family (18). In otherwise healthy adults with chickenpox pneumonia, intravenous acyclovir appears to hasten recovery (175).…”

Section: Ribavirinmentioning

confidence: 99%

Antiviral therapy: current concepts and practices

Bean

1992

Clin Microbiol Rev

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Drugs capable of inhibiting viruses in vitro were described in the 1950s, but real progress was not made until the 1970s, when agents capable of inhibiting virus-specific enzymes were first identified. The last decade has seen rapid progress in both our understanding of antiviral therapy and the number of antiviral agents on the market. Amantadine and ribavirin are available for treatment of viral respiratory infections. Vidarabine, acyclovir, ganciclovir, and foscarnet are used for systemic treatment of herpesvirus infections, while ophthalmic preparations of idoxuridine, trifluorothymidine, and vidarabine are available for herpes keratitis. For treatment of human immunodeficiency virus infections, zidovudine and didanosine are used. Immunomodulators, such as interferons and colony-stimulating factors, and immunoglobulins are being used increasingly for viral illnesses. While resistance to antiviral drugs has been seen, especially among AIDS patients, it has not become widespread and is being intensely studied. Increasingly, combinations of agents are being used: to achieve synergistic inhibition of viruses, to delay or prevent resistance, and to decrease dosages of toxic drugs. New approaches, such as liposomes carrying antiviral drugs and computer-aided drug design, are exciting and promising prospects for the future.

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Acyclovir treatment of varicella in otherwise healthy children

Cited by 172 publications

References 13 publications

Antiviral Therapy of Herpes simplex and Varicella-zoster Virus Infections

Antiviral Therapy of Herpes simplex and Varicella-zoster Virus Infections

Progress in the Clinical Management of Herpesvirus Infections

Antiviral therapy: current concepts and practices

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