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Practice Best Practice

Herpes zoster infection

BMJ 2019; 364 doi: (Published 10 January 2019) Cite this as: BMJ 2019;364:k5095

Herpes Zoster Infection

Dear BMJ

I have just read the article regarding treatment of the above. I believe, where a patient has had herpes zoster infection before, and they have the tingling/pain signalling the reactivation of herpes zoster infection that they recognise from previous infections, that acyclovir oral should be prescribed at that point.

I am aware that many doctors would not prescribe until the rash presents, and I believe this puts patients at unnecessary risk of long term post shingles pain for no reason.

From the article, I believe overall it gives the impression that prescribing should happen on presentation of the rash. Can this be clarified?

Thank you
Eileen Hoogduyn

Competing interests: No competing interests

11 January 2019
Eileen Hoogduyn
Pharmacist Prescriber
NHS Scotland