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Treatment of herpes simplex gingivostomatitis with aciclovir in children: a randomised double blind placebo
1Paediatric Ambulatory Care Unit, Golda Medical Centre, Hasharon Hospital, Petah Tiqva, Israel. hshmuely@post.tau.ac.il
Insights
Aciclovir suspension effectively treats herpetic gingivostomatitis in young children. Early treatment shortens lesion duration, fever, and viral shedding, reducing infectivity.
Area of Science:
- Pediatric infectious diseases
- Antiviral therapy efficacy
- Herpes simplex virus infections
Background:
- Herpetic gingivostomatitis is a common viral infection in young children.
- Primary herpes simplex virus (HSV) infection often presents with painful oral lesions and systemic symptoms.
- Prompt and effective treatment is crucial to alleviate symptoms and reduce transmission.
Purpose of the Study:
- To evaluate the effectiveness of aciclovir suspension in treating herpetic gingivostomatitis in pediatric patients.
- To compare the clinical outcomes of aciclovir treatment versus placebo.
Main Methods:
- A randomized, double-blind, placebo-controlled study was conducted.
- Participants included 72 children aged 1-6 years with early-stage gingivostomatitis.
- Treatment involved aciclovir suspension (15 mg/kg, five times daily for seven days) or a placebo.
Main Results:
- Aciclovir significantly reduced the duration of oral lesions (median 4 vs. 10 days).
- Faster resolution of fever, extraoral lesions, and difficulties with eating and drinking was observed in the aciclovir group.
- Viral shedding was significantly shorter in children treated with aciclovir (median 1 vs. 5 days).
Conclusions:
- Oral aciclovir, initiated within 72 hours of symptom onset, effectively shortens the clinical course of herpetic gingivostomatitis.
- Aciclovir treatment reduces the duration of symptoms and the period of viral infectivity in affected children.
- Further research is recommended to determine optimal dosing and treatment duration.
Objectives:
To examine the efficacy of aciclovir suspension for treating herpetic gingivostomatitis in young children.
Design:
Randomised double blind placebo controlled study.
Setting:
Day care unit of a tertiary paediatric hospital.
Subjects:
72 children aged 1-6 years with clinical manifestations of gingivostomatitis lasting less than 72 hours; 61 children with cultures positive for herpes simplex virus finished the study.
Main Outcome Measures:
Duration of oral lesions, fever, eating and drinking difficulties, and viral shedding.
Intervention:
Aciclovir suspension 15 mg/kg five times a day for seven days, or placebo.
Results:
Children receiving aciclovir had oral lesions for a shorter period than children receiving placebo (median 4 v 10 days (difference 6 days, 95% confidence interval 4.0 to 8.0)) and earlier disappearance of the following signs and symptoms: fever (1 v 3 days (2 days, 0.8 to 3.2)); extraoral lesions (lesions around the mouth but outside the oral cavity) (0 v 5.5 days (5.5 days, 1.3 to 4.7)); eating difficulties (4 v 7 days (3 days, 1.31 to 4.69)); and drinking difficulties (3 v 6 days (3 days, 1.1 to 4.9)). Viral shedding was significantly shorter in the group treated with aciclovir (1 v 5 days (4 days, 2.9 to 5.1)).
Conclusions:
Oral aciclovir treatment for herpetic gingivostomatitis, started within the first three days of onset, shortens the duration of all clinical manifestations and the infectivity of affected children. Further studies are needed to evaluate the ideal dose and length of treatment.