REPLY
Does Acyclovir Worsen Late Varicella?
Mark R. Wallace;
Stephanie K. Brodine; and
Edward C. Oldfield
1 March 1993 | Volume 118 Issue 5 | Pages 394-395
IN RESPONSE:
We appreciate Dr. Klein's comments on our recent article. We also were puzzled by the statistically significant differences in new lesion formation and maximum number of lesions favoring placebo in the late treatment group (24 to 72 hours after rash onset). We suspect that these differences are partially the result of the randomization of a relatively small group of patients (72) yielding a late placebo group with a lesion count at entry of 20% less than that of the acyclovir group. Not surprisingly, given their initially lower lesion counts, the placebo group had a lower maximum number of lesions. Despite the favoring of the placebo group by other parameters, the duration of fever was slightly less in the acyclovir-treated group. We can think of no reason why acyclovir would worsen the course of varicella in late-presenting patients. We agree with Dr. Klein's conclusion that delayed administration (> 24 hours after rash onset) of acyclovir in patients with uncomplicated varicella is unwarranted.
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