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January 17, 1986, Vol 255, No. 3 >
ARTICLE | January 17, 1986

Acyclovir Therapy for Herpes Zoster: Advantages and Adverse Effects FREE

Henry H. Balfour, Jr, MD
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Address editorial communications to the Editor, 535 N Dearborn St, Chicago, IL 60610.


JAMA. 1986;255(3):387-388. doi:10.1001/jama.1986.03370030107039
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References

Acyclovir sodium administered intravenously to treat acute herpes zoster in an immunocompromised patient was associated with side effects as described by Sylvester et al in this issue of The Journal.1 The CASE REPORT raises several important questions: Should acyclovir be used for treatment of herpes zoster, and, if so, what dosage is appropriate and what adverse effects can be expected?

Acyclovir is a specific inhibitor of the DNA polymerase of all five members of the human herpesvirus family and thus the drug is potentially useful for treatment of many herpes-virus-associated diseases.

The median sensitivity of herpes simplex virus (HSV) type 2 strains to acyclovir as measured by plaque reduction is 0.4μM.2 Plasma concentrations fivefold higher than this can be attained by ingesting one 200-mg acyclovir capsule. Therefore, it is not surprising that acyclovir is the drug of choice for treatment of primary3 and recurrent4 genital herpes, herpes

REFERENCES

1 +
Sylvester RK, Ogden WB, Draxler CA, et al:  Vesicular eruption: A local complication of concentrated acyclovir infusions . JAMA 1986;:255:385-386.
2 +
Balfour HH Jr:  Acyclovir , in Peterson PK, Verhoef J (eds): Antimicrobial Agents 1986: Annual 1 . Amsterdam, Elsevier, in press.
3 +
Bryson YJ, Dillon M, Lovett M, et al:  Treatment of first episodes of genital herpes simplex virus infection with oral acyclovir: A randomized double-blind controlled trial in normal subjects . N Engl J Med 1983;;308:916-921.
4 +
Reichman RC, Badger GJ, Mertz GJ, et al:  Treatment of recurrent genital herpes simplex infections with oral acyclovir: A controlled trial . JAMA 1984;;251:2103-2107.
5 +
Whitley RJ, Alford CA, Hirsch MS, et al:  Herpes simplex encephalitis: Adenine arabinoside versus acyclovir therapy . N Engl J Med , in press.
6 +
Mitchell CD, Bean B, Gentry SR, et al:  Acyclovir therapy for mucocutaneous herpes simplex infections in immunocompromised patients . Lancet 1981;;1:1389-1392.
7 +
Balfour HH Jr, Bean B, Laskin OL, et al:  Acyclovir halts progression of herpes zoster in immunocompromised patients . N Engl J Med 1983;;308:1448-1453.
8 +
Bean B. Braun C, Balfour HH Jr:  Acyclovir therapy for acute herpes zoster . Lancet 1982;;2:118-121.
9 +
Selby P, Powles RL, Blake S, et al:  Amino(hydroxyethoxymethyl)purine: A new well-absorbed prodrug of acyclovir . Lancet 1984;;2:1428-1430.
10 +
Bean B, Aeppli D:  Adverse effects of high-dose intravenous acyclovir in ambulatory patients with acute herpes zoster . J Infect Dis 1985;;151:362-365.
11 +
Brigden D, Rosling AE, Woods NC:  Renal function after acyclovir intravenous injection . Am J Med 1982;;73( (suppl 1A) ):182-185.
12 +
Wade JC, Meyers JD:  Neurologic symptoms associated with parenteral acyclovir treatment after marrow transplantation . Ann Intern Med 1983;;98:921-925.
13 +
Whitley RJ, Soong S-J, Dolin R, et al:  Early vidarabine therapy to control the complications of herpes zoster in immunosuppressed patients . N Engl J Med 1982;;307:971-975.
14 +
McKendrick MW, Care C, Burke C, et al:  Oral acyclovir in herpes zoster . J Antimicrob Chemother 1984;;14:661-665.

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1 +
Sylvester RK, Ogden WB, Draxler CA, et al:  Vesicular eruption: A local complication of concentrated acyclovir infusions . JAMA 1986;:255:385-386.
2 +
Balfour HH Jr:  Acyclovir , in Peterson PK, Verhoef J (eds): Antimicrobial Agents 1986: Annual 1 . Amsterdam, Elsevier, in press.
3 +
Bryson YJ, Dillon M, Lovett M, et al:  Treatment of first episodes of genital herpes simplex virus infection with oral acyclovir: A randomized double-blind controlled trial in normal subjects . N Engl J Med 1983;;308:916-921.
4 +
Reichman RC, Badger GJ, Mertz GJ, et al:  Treatment of recurrent genital herpes simplex infections with oral acyclovir: A controlled trial . JAMA 1984;;251:2103-2107.
5 +
Whitley RJ, Alford CA, Hirsch MS, et al:  Herpes simplex encephalitis: Adenine arabinoside versus acyclovir therapy . N Engl J Med , in press.
6 +
Mitchell CD, Bean B, Gentry SR, et al:  Acyclovir therapy for mucocutaneous herpes simplex infections in immunocompromised patients . Lancet 1981;;1:1389-1392.
7 +
Balfour HH Jr, Bean B, Laskin OL, et al:  Acyclovir halts progression of herpes zoster in immunocompromised patients . N Engl J Med 1983;;308:1448-1453.
8 +
Bean B. Braun C, Balfour HH Jr:  Acyclovir therapy for acute herpes zoster . Lancet 1982;;2:118-121.
9 +
Selby P, Powles RL, Blake S, et al:  Amino(hydroxyethoxymethyl)purine: A new well-absorbed prodrug of acyclovir . Lancet 1984;;2:1428-1430.
10 +
Bean B, Aeppli D:  Adverse effects of high-dose intravenous acyclovir in ambulatory patients with acute herpes zoster . J Infect Dis 1985;;151:362-365.
11 +
Brigden D, Rosling AE, Woods NC:  Renal function after acyclovir intravenous injection . Am J Med 1982;;73( (suppl 1A) ):182-185.
12 +
Wade JC, Meyers JD:  Neurologic symptoms associated with parenteral acyclovir treatment after marrow transplantation . Ann Intern Med 1983;;98:921-925.
13 +
Whitley RJ, Soong S-J, Dolin R, et al:  Early vidarabine therapy to control the complications of herpes zoster in immunosuppressed patients . N Engl J Med 1982;;307:971-975.
14 +
McKendrick MW, Care C, Burke C, et al:  Oral acyclovir in herpes zoster . J Antimicrob Chemother 1984;;14:661-665.

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