Comparison of Two Different Doses of Acyclovir Therapy in Herpes Zoster
Abstract
ABSTRACT
Background: Acyclovir, antiviral therapy is the corner stone in the management of herpes zoster, it leads to more rapid resolution of the skin lesions and, most importantly, decreased the duration of zoster-associated pain.
Objectives: To study the therapeutic efficacy of low dose (400 mg) of acyclovir compared to the usual dose schedule (800 mg). Timing for the initiation of the antiviral therapy was also evaluated.
Methods: Double blind controlled therapeutic trial. A total of 117 patients with herpes zoster were included. The patients on active treatment (n=78) were divided into 40 patients with early presentation (less than 72 hours from the appearance of the rash), and 38 patients with late presentation. Both groups were randomized into two equally sized intervention groups, one received acyclovir in the usual dose 800 mg x 5/day, and another one receiving 400 mg x 5/day. Another 39 patients who presented late (after 72 hours) were left untreated and served as a control group
Results: This study showed an almost comparable result in both doses of acyclovir (800 mg and 400 mg) on skin lesion disappearance and pain resolution. Both doses schedule were associated with significant reduction in response time compared to untreated controls. The response observed in the late presentation group was so small to be of clinical relevance. The best and earliest response (resolution of all lesions) was observed with the high dose early presentation group, all subjects in this group were respondents by the end of 3rd week. This effect was only slightly better than the 90% response rate among low dose early presentation group.
Conclusion: The use of low dose (400 mg) Acyclovir for the treatment of herpes zoster infection is almost as effective as the usual 800 mg dosage. Such a treatment regime is more effective in the early (first 72 hours) presentation group of patients, but still have a place in the management of late presentation group
Copyright (c) 2012 Iraqi Medical Journal
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