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Acyclovir treatment of varicella in otherwise healthy children
H H Balfour1, J M Kelly, C S Suarez
1Department of Laboratory Medicine and Pathology, University of Minnesota Health Sciences Center, Minneapolis 55455.
Insights
Oral acyclovir (antiviral medication) significantly reduces the duration and severity of chickenpox (varicella) in healthy children. This antiviral treatment is well-tolerated and effective in managing varicella symptoms.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Varicella (chickenpox) is a common viral infection in children.
- Effective antiviral treatments can mitigate disease severity and duration.
Purpose of the Study:
- To evaluate the efficacy of oral acyclovir in treating varicella in healthy children.
- To assess the impact of acyclovir on symptom duration, lesion severity, and complication rates.
Main Methods:
- A randomized, placebo-controlled, double-blind trial was conducted.
- 102 children aged 5-16 with confirmed varicella received either oral acyclovir or a placebo.
- Dosage of acyclovir was age-adjusted and administered for 5-7 days.
Main Results:
- Acyclovir group showed faster defervescence (1 day vs 2 days) and quicker healing (3 days vs 2 days).
- Fewer skin lesions were observed in the acyclovir group (median 500 vs 336).
- No significant difference in complication rates or adverse effects was noted between groups.
Conclusions:
- Oral acyclovir is a beneficial and well-tolerated treatment for varicella in healthy children.
- Acyclovir effectively reduces the clinical burden of chickenpox.
- Long-term antibody responses to varicella-zoster virus were comparable between groups after one year.
Study Objective:
To determine whether acyclovir administered orally affects the duration and severity of varicella in otherwise normal children.
Design:
Randomized, placebo-controlled, double-blind trial.
Setting:
Patients' residence and university hospital clinic.
Patients:
One hundred five children between 5 and 16 years of age with laboratory-confirmed varicella entered the study. Of the 102 who were included in the final analysis, 50 received acyclovir and 52 received placebo.
Intervention:
Placebo or acyclovir was given orally four times daily, for 5 to 7 days. The acyclovir dose was adjusted as follows: 5 to 7 years of age, 20 mg/kg; 7 to 12 years, 15 mg/kg; and 12 to 16 years, 10 mg/kg.
Measurements And Main Results:
Acyclovir recipients, compared with the placebo group, defervesced sooner (median, 1 day vs 2 days; p = 0.001), experienced onset of cutaneous healing sooner, as reflected by a decrease in number of lesions (median, 3 days vs 2 days; p = 0.002), and had fewer skin lesions (median, 500 vs 336; p = 0.02). Acyclovir did not significantly change the rate of complications of varicella (10% in the acyclovir group vs 13.5% among placebo subjects). Adverse drug effects were not observed. Acyclovir recipients had lower geometric mean serum antibody titers to varicella-zoster virus than their placebo counterparts 4 weeks after the onset of illness, but antibody titers in both groups were similar 1 year later.
Conclusions:
These results provide evidence that acyclovir is useful and well tolerated for treatment of varicella in otherwise healthy children.