Oral acyclovir to prevent dissemination of varicella in immunocompromised children

Area of Science:

• Pediatric Infectious Diseases
• Virology
• Pharmacology

Background:

• Varicella (chickenpox) poses a significant risk to immunocompromised children.
• Intravenous acyclovir has been the standard treatment, but oral administration is desirable for ease of use.
• Assessing the efficacy and safety of oral acyclovir in this vulnerable population is crucial.

Purpose of the Study:

• To evaluate the safety and efficacy of oral acyclovir in treating varicella in immunocompromised children.
• To compare the outcomes of oral acyclovir treatment with historical placebo data.

Main Methods:

• Twenty-five immunocompromised children with varicella received oral acyclovir (800 mg, five times daily for 7 days).
• Outcomes were monitored for disease resolution, dissemination, and adverse events.
• Compared outcomes to a historical placebo group.

Main Results:

• All patients achieved disease healing with no evidence of dissemination.
• Only two patients required a switch to intravenous acyclovir, a statistically significant reduction (P < 0.01) compared to the historical placebo group (12/25).
• The only reported adverse event was mild, self-limiting diarrhea in nine patients.

Conclusions:

• Oral acyclovir is a safe and effective treatment option for varicella in immunocompromised children.
• Oral acyclovir significantly reduces the need for intravenous therapy.
• Close medical observation of patients receiving oral acyclovir is recommended.