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ACYCLOVIR FOR SHINGLES.

The pain of herpes zoster (shingles) causes considerable morbidity in elderly persons. A multicenter placebo-controlled study in the United Kingdom assessed the efficacy of oral acyclovir (800 mg five times per day for one week) in 364 patients over 60 years old. When treatment began within 48 hours of the appearance of the rash, patients had moderate but statistically significant reductions in pain and in the extent of the rash. Unfortunately, there was no effect on the incidence or severity of postherpetic neuralgia.

A multicenter study in the U.S. yielded similar short- term improvements in pain and skin rash when the same dose of acyclovir was used for ten days. In contrast to the British study, however, patients treated with acyclovir had slight reductions in postherpetic neuralgia, as compared with patients given placebo. A lower dose of acyclovir (400 mg five times per day) was ineffective.

Acyclovir was well tolerated in both studies. Although the results of treatment may not be dramatic, the drug appears suitable as short-term therapy for elderly patients with shingles. But the jury is still out on whether acyclovir substantially reduces the likelihood of postherpetic neuralgia.

— ASB

Published in Journal Watch General Medicine September 20, 1988

Citation(s):

Huff J C; Bean B; Balfour H H, Jr et al. Therapy of herpes zoster with oral acyclovir. Am J Med 1988 Aug 29 85 Suppl 2A 84-89.

Wood M J; Ogan P H; McKendrick M W; Care C D; McGill J I; Webb E M. Efficacy of oral acyclovir treatment of acute herpes zoster. Am J Med 1988 Aug 29 85 Suppl 2A 79-83.