LETTER
Does Acyclovir Worsen Late Varicella?
Robert S. Klein
1 March 1993 | Volume 118 Issue 5 | Pages 394-395
TO THE EDITOR:
In their double-blind, placebo-controlled, randomized trial, Wallace and associates [1] clearly showed a clinical benefit of oral acyclovir in the treatment of varicella when administered to immunocompetent adults in the first 24 hours after symptom onset. The lack of benefit from later administration was thought to be due to viral replication already being controlled by the intact immune system, making antiviral therapy superfluous.
Their data suggest that late administration of acyclovir might indeed worsen the course of disease, as shown by an increased number of days of new lesion formation (3.0 compared with 2.3 days, P = 0.03) and a greater maximum number of lesions (233 compared with 158 lesions, P = 0.03). Although not statistically different, time to maximum number of skin lesions, time to onset of cutaneous healing, and time to complete crusting of lesions all were longer in the acyclovir group.
1. Wallace MR, Bowler WA, Murray NB, Brodine SK, Oldfield EC 3d. Treatment of adult varicella with oral acyclovir. A randomized, placebo-controlled trial. Ann Intern Med. 1992; 117:358-63.
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