Acyclovir concentrations and tolerance during repetitive administration for 18 days

Area of Science:

• Pharmacology
• Nephrology
• Transplant Medicine

Background:

• Acyclovir is an antiherpetic agent used in immunocompromised patients.
• Bone marrow transplant recipients are susceptible to viral infections and require prophylactic treatment.
• Assessing the safety and efficacy of prophylactic acyclovir is crucial in this vulnerable population.

Purpose of the Study:

• To evaluate the prophylactic efficacy and safety of acyclovir in bone marrow transplant recipients.
• To determine the impact of acyclovir on renal function, specifically glomerular filtration rate (GFR).
• To assess acyclovir's pharmacokinetic profile in relation to renal function changes.

Main Methods:

• A double-blind, randomized, placebo-controlled trial was conducted.
• Ten bone marrow transplant recipients received acyclovir, and ten received a placebo for 18 days.
• Renal function (GFR), plasma acyclovir concentrations, and liver function tests (SGOT, SGPT) were monitored.

Main Results:

• Renal glomerular function declined in both acyclovir and placebo groups, with no significant difference between them.
• Plasma acyclovir concentrations increased over time, correlating with the observed decreases in GFR in both groups.
• Acyclovir treatment showed statistically significant increases in SGOT and SGPT levels compared to placebo.

Conclusions:

• Acyclovir administration did not significantly affect renal glomerular function in bone marrow transplant recipients.
• Observed changes in acyclovir pharmacokinetics were attributed to GFR decline, not drug toxicity.
• Elevated SGOT and SGPT levels were the primary adverse effects noted with acyclovir treatment.