Topical acyclovir in the treatment of genital herpes: a comparison with systemic therapy

Fiddian, A P; Kinghorn, G R; Goldmeier, David; Rees, Elisabeth; Rodin, P.; Thin, R N; Koning, G. A. J. de

doi:10.1093/jac/12.suppl_b.67

Cited by 65 publications

(21 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The minimal efficacy of topical ACV ointment in the present studies (19% reduction in lesion area) and in other experiments (8,22,23) parallels the disappointing results with this preparation in recurrent cutaneous human HSV infections in normal hosts (3,17,20,21,24,27). Similarly, the better results (31 to 73% reduction in lesion area) seen with topical PFA and topical ACV cream in our model system find parallels in the recent clinical reports which indicate that these formulations may be more effective than ACV ointment (6,7,15,19,(25)(26)(27). The human experience does not support superiority of topical PFA over ACV cream, as was found in the guinea pig.…”

supporting

confidence: 89%

“…Modest success has been claimed for PFA cream (19,26) and ACV cream (6,7,15,25), while the majority of studies with ACV ointment in recurrent disease have failed to demonstrate any clinical benefit (3,17,20,21,24,27 (8) were 14.2 and 0.14 ,ug/ml, respectively. Sixteen Hartley strain, outbred female albino guinea pigs weighing 350 to 400 g each were inoculated with HSV-1 E115 in six different areas on the depilated dorsum by multiple shallow punctures as originally described by Hubler et al (14).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Comparison of foscarnet cream, acyclovir cream, and acyclovir ointment in the topical treatment of experimental cutaneous herpes simplex virus type 1 infection

Spruance¹,

Freeman²,

Sheth³

1986

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Topical foscarnet (PFA) and acyclovir (ACV) were compared in the dorsal cutaneous guinea pig model of herpes simplex virus type 1 infection. The relative order of efficacy was PFA cream>ACV cream>ACV ointment. In vitro studies demonstrated that PFA and ACV formulated in cream vehicles penetrated through guinea pig skin 7-to 10-fold faster than did ACV in ointment.Foscarnet cream (sodium phosphonoformate [PFA]), acyclovir (ACV) cream, and ACV ointment are topical antiviral preparations which have received extensive clinical evaluation as treatments for recurrent herpes simplex labialis and genitalis in normal, nonimmunocompromised subjects. Modest success has been claimed for PFA cream (19,26) and ACV cream (6,7,15,25), while the majority of studies with ACV ointment in recurrent disease have failed to demonstrate any clinical benefit (3,17,20,21,24,27 (8) were 14.2 and 0.14 ,ug/ml, respectively. Sixteen Hartley strain, outbred female albino guinea pigs weighing 350 to 400 g each were inoculated with HSV-1 E115 in six different areas on the depilated dorsum by multiple shallow punctures as originally described by Hubler et al. (14). Treatment of each infection site with 200 to 250 mg of cream or ointment was begun 24 h after inoculation and continued once per day for 3 days. The frequency of dosing was limited because some formulations were irritating to the skin. This protocol allowed for 12 comparisons between each drug and its contralaterally applied vehicle as well as comparisons of efficacy between each of the four different antiviral formulations. The severity of the infection at each treatment site was evaluated on the day after completion of the treatment regimen by examining the number of lesions, the diameter of lesions, the total lesion area, and the quantity of virus in excised skin. Further details of these procedures have been previously described (8,22 Drug flux was determined from a steady-state plot of drug concentration versus time. Further details of these procedures are available elsewhere (8,22,23).Lesion severity between drug and vehicle control-treated sites were compared by the Wilcoxon signed-rank test. The percent efficacies of different drug formulations were compared by the Mann-Whitney rank-sum procedure and in vitro flux values by Student's t test. All probability determinations were two tailed, and a P of c 0.05 was considered to be significant.The results of the in vivo studies are shown in Table 1. Compared with lesion severity at vehicle control-treated sites, reductions of the mean number of lesions by 3% PFA, 0.3% PFA, ACV cream, and ACV ointment were 54, 36, 19, and -8%, respectively; reductions in the mean lesion area were 73, 52, 31, and 19%; and the reductions in mean lesion virus titer effected by these treatments were 90, 80, 75, and 60%. The greater reduction in number of lesions by 3% PFA, 0.3% PFA, and ACV cream compared with that of ACV ointment was statistically significant (P c 0.03). Both 3% and 0.3% PFA were significantly more effective in reducing lesion area t...

show abstract

supporting

confidence: 89%

mentioning

confidence: 99%

Comparison of foscarnet cream, acyclovir cream, and acyclovir ointment in the topical treatment of experimental cutaneous herpes simplex virus type 1 infection

Spruance¹,

Freeman²,

Sheth³

1986

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…This was added to enhance the penetration of interferon [19][20][21], Although we cannot unequivocally exclude the possibility that DMSO enhances the antiviral activity of interferon, we can confidently assert that DMSO absorption was not signif icant and that there was no systemic toxicity (as shown by DMSO drug levels, blood chemistries, hematologic pro files and physical examination).…”

Section: Discussionmentioning

confidence: 90%

“…Fiddian ct al. [ 19] reported that 62% of the 137 patients enrolled in their acyclovir cream study for recurrent genital HSV completed that clinical trial. In a larger multicenter study evaluating acyclovir ointment in recurrent genital herpes.…”

Section: Discussionmentioning

confidence: 99%

“…These investigators reported not only a decrease in the duration of episodes and severity of symptoms but also a decrease in the subsequent recurrence rate [16][17][18]. Top ical acyclovir in an aqueous propylene glycol cream base has shown significant efficacy in the treatment of recurrent genital HSV infections in controlled clinical trials [19][20][21][22]. On the other hand.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Topical Alpha-lnterferon Ointment with Dimethyl Sulfoxide in the Treatment of Recurrent Genital Herpes simplex

Shupack¹,

Stiller²,

Davis³

et al. 1992

Dermatology

View full text Add to dashboard Cite

The recent in vivo appearance of acyclovir-resistant strains of herpes simplex virus stresses the need for new therapeutic agents to combat this common virus. Topical interferon preparations may help fill this void. In the present study dimethyl sulfoxide was combined with α-interferon in an ointment base to increase percutaneous penetration. In this double-blind, placebo-controlled trial, patients with recurrent genital herpes simplex using the topical α-interferon preparation had a more rapid cessation of viral shedding when compared to the placebo group (66% culture negative on day 1 vs. 25% of placebo patients; p < 0.02). In the 90-day post-treatment period, interferon-treated patients had fewer recurrences than their placebo-treated counterparts (1.18 vs. 2.25). This reduction while not statistically significant was encouraging (p < 0.10).

show abstract

Interventions for men and women with their first episode of genital herpes

Heslop

Roberts

Flower

et al. 2016

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Topical acyclovir in the treatment of genital herpes: a comparison with systemic therapy

Cited by 65 publications

References 0 publications

Comparison of foscarnet cream, acyclovir cream, and acyclovir ointment in the topical treatment of experimental cutaneous herpes simplex virus type 1 infection

Comparison of foscarnet cream, acyclovir cream, and acyclovir ointment in the topical treatment of experimental cutaneous herpes simplex virus type 1 infection

Topical Alpha-lnterferon Ointment with Dimethyl Sulfoxide in the Treatment of Recurrent Genital Herpes simplex

Interventions for men and women with their first episode of genital herpes

Contact Info

Product

Resources

About