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Management of primary herpetic gingivostomatitis in young children
1Department of Pediatrics, School of Medicine, State University of New York at Buffalo, Women and Children's Hospital of Buffalo, Buffalo, NY 14222, USA. hfaden@upa.chob.edu
Insights
Treatment for primary herpetic gingivostomatitis in children often involved topical agents like Maalox/diphenhydramine or viscous lidocaine. Acyclovir was underutilized, and topical agent administration was frequently problematic.
Area of Science:
- Pediatric infectious diseases
- Oral medicine
Background:
- Primary herpetic gingivostomatitis is a common viral infection in children.
- Effective symptom management is crucial for patient comfort and recovery.
Observation:
- A retrospective chart review identified 48 cases of primary herpetic gingivostomatitis treated between 1999 and 2003.
- Patients ranged from 8 months to 12 years old, with a median age of 2 years 7 months.
Findings:
- All patients received fluids and analgesics.
- Topical therapies included Maalox/diphenhydramine (73%), viscous lidocaine (15%), and acyclovir (17%).
- Eleven patients received multiple topical treatments, and administration methods/dosing for topical agents were often inconsistent.
Implications:
- Current treatment protocols for primary herpetic gingivostomatitis may not be optimal.
- There is a need for standardized guidelines for topical agent administration.
- Increased utilization of acyclovir may be beneficial.
Objective:
To review the treatment of primary herpetic gingivostomatitis at a children's hospital.
Methods:
A review of charts from 1999 to 2003.
Results:
Forty-eight cases were identified. They ranged in age from 8 months to 12 years, with a median age of 2 years 7 months. All children were treated with fluids and analgesics; 11 children were treated with fluids and analgesics exclusively. Thirty-five children were treated with a mixture of Maalox and diphenhydramine, 8 with acyclovir, and 7 with viscous lidocaine; 11 children were treated with 2 or more of these regimens. Both the Maalox and diphenhydramine mixture and the viscous lidocaine were administered as swish and swallow, swish and spit, or by application with a swab as frequently as every hour or as infrequently as every 8 hours.
Conclusions:
Topical therapy with Maalox and diphenhydramine or viscous lidocaine was administered to 73% and 15% of the patients, respectively, whereas acyclovir was administered to only 17%. Dosing and administration of topical agents in the treatment of primary herpetic gingivostomatitis in preschoolers were problematic. Acyclovir was not being used as often as it could have been.
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