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Is aciclovir prophylaxis necessary after bone marrow transplantation?
Infection
|May 1, 1986
Summary
Using aciclovir for early herpes simplex virus treatment in bone marrow transplant patients is cost-effective. This approach reduces drug use and lowers the risk of antiviral resistance.
Area of Science:
- Infectious Diseases
- Hematology
- Pharmacoeconomics
Background:
- Herpes simplex virus (HSV) infections are a common complication post-allogeneic bone marrow transplant (BMT).
- Prophylactic use of antiviral medications like aciclovir is standard, but raises concerns about cost and resistance.
- Evaluating treatment strategies is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To compare the cost-effectiveness of prophylactic versus early treatment with aciclovir for HSV infections in BMT recipients.
- To assess the incidence of HSV infections in patients receiving aciclovir solely for therapeutic purposes.
Main Methods:
- A retrospective study was conducted on 44 allogeneic bone marrow transplant recipients.
- Patients received aciclovir only for therapeutic indications.
- HSV infections were monitored through clinical signs and routine viral cultures.
Main Results:
- 18 HSV infections occurred in 15 of 33 HSV-seropositive patients post-transplant.
- Subclinical HSV was detected in ten patients via routine viral cultures.
- Intravenous aciclovir treatment for mucocutaneous infections showed rapid response in all cases.
Conclusions:
- Restricting aciclovir to therapeutic use significantly reduced overall drug consumption.
- This strategy diminished treatment costs and mitigated the risk of developing aciclovir resistance.
- Early treatment of HSV infections in BMT patients is a viable and cost-effective approach.