Education And Debate

No reason not to treat

BMJ 1995; 310 doi: (Published 14 January 1995) Cite this as: BMJ 1995;310:109
  1. Henry H Balfour, professor of laboratory medicine and pathologya
  1. a University of Minnesota Medical School, Minneapolis, Minnesota, USA
  1. Correspondence to: Box 437 UMHC, 15–144 PWB Harvard Street at East. RiverParkway, Minneapolis, Minnesota, USA 55455.

    Acyclovir has been shown to shorten the course of chickenpox in otherwise healthy children by 25–33% according to three placebo controlled trials in the United States.1 2 3 All clinical events monitored were favourably affected by acyclovir, with the most important differences being reductions in degree and duration of fever, constitutional illness score, and number of residual lesions present at the 28 day follow up examination. No appreciable adverse events were reported. These studies also identified two subsets of patients particularly suitable for acyclovir therapy: adolescents and children who acquired chickenpox from a family member.

    Need for treatment

    The main controversy regarding use of acyclovir is not its clinical usefulness, which is scientifically incontestable, but whether treatment is needed for a relatively benign disease. To fully appreciate the impact of acyclovir on chickenpox you need to make daily visits to treated subjects and controls, as our research nurse clinicians …

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