Per una pediatria basata sull'evidenza
Varicella e aciclovir
ACYCLOVIR IN CHICKEN POX: QUESTIONS AND ANSWERS
ELENA NERI, IRENE BRUNO, CHRISTINE SALVATORE, FEDERICA BRAIDA1, EGIDIO BARBI
Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste;1Clinica Pediatrica, Università di Udine
Giugno 2000 - pagg. 377 -381
Abstract
Chicken pox is still a common disease, usually with a favourable course. Complications are
rare (2-3/100.000) in immunocompetent patients. The Authors review the published experience
regarding treatment with acyclovir and conclude that the advantage is marginall
(25% reduction of the duration of symptoms), while there is no reduction in the rate of complications.
Acyclovir should be used in immunocompromised patients including primary immune
deficiencies, patients treated with steroids or long-term salycilates, patients affected
by chronic lung diseases, eczema, diabetes and heart diseases.
Classificazione MeSH
Bibliografia
1. Marchisio P, Principi N. La varicella nel
bambino e nell’adolescente: terapia e profilassi.
RIP 1998;24:9-21.
2. Lieu TA, Black SB, Rieser N, et al. The cost of childhood chichenpox. Parents’ perspective. Pediatr Infect Dis J 1994;13:173-7.
3. Nathwani D. Economic issues in prevention and treatment of VZV infections. Herpes 1995;2:21-2.
4. Nathwani D. Effectiveness of Acyclovir for varicella infections in immunocompetent patients. A British perspective. Infect Dis Clin Pract 1995;4:495-585.
5. Fornaro P, et al. Epidemiology and cost analysis of varicella in Italy: results of a sentinel study in the pediatric practice. Italian Sentinel Group on Pediatric Infectious Diseases. Pediatr Infect Dis J 1999;18:414- 19.
6. Balfour HH jr. Varicella: una malattia curabile che vale la pena curare. RIP 1998;24: 1051-52.
7. Balfour HH jr, et al. Acyclovir treatment of varicella in otherwise healty children. J Pediatr 1990;116:633-9.
8. Christophers J, et al. Survey of resistance of herpes simplex virus to Acyclovir in North-west England. Antimicrob Agents Chemother 1998;42:868-72.
9. Jaeggi A, Zurbruegg RP, Aebi C. Complications of varicella in a defined central European population. Arch Dis Child 1998; 79(6):472-7.
10. Suga ES, et al. Effect of oral Acyclovir against primary and secondary viremia in incubation period of Varicella. Arch Dis Child 1993;69:639-43.
11. Balfour, et al. Management of acyclovirresistant herpes simplex and varicella-zoster virus infections. J Acquir Immune Deficit Syndr 1994;7(3):254-60.
12. Homopolymer mutational hot spots mediate herpes simplex virus resistance to acyclovir. J Virol 1997;71(5):3872-8.
13. Ida, et al. Emergence of resistance to acyclovir and pencyclovir in varicella-zoster virus and genetic analysis of acyclovir-resistant variants. Antiviral Res 1999;40(3):155-66.
14. Mah, Kuo, Wei, Tsai, Liu. Screening for acyclovir-resistant herpes simplex virus isolates from clinical samples. Chung Hua Min Kuo Wei Sheng Wu Chi Mien I Hsueh Tsa Chih 30;1:51-4.
15. Nursoy MA, Bakir M, Barlan IB, Basaran MM. The course of chickenpox in asthmatic children receiving inhaled budesonide. Pediatr Infect Dis J 1997;16(1):74-7.
16. Carcao MD, Lau RC, Gupta A, Huerter H, Koren G, King SM. Sequential use of intravenous and oral acyclovir in the therapy of varicella in immunocompromised children. Pediatr Infect Dis J 1998;17(7):626-31.
17. Giaquinto C, Cantarutti C, Sturkenboom M. The natural history of varicella zoster infection in childhood: results from a large prospective study. 38 ICAAC, S. Diego (USA) 1998, Abstract 32H3.
2. Lieu TA, Black SB, Rieser N, et al. The cost of childhood chichenpox. Parents’ perspective. Pediatr Infect Dis J 1994;13:173-7.
3. Nathwani D. Economic issues in prevention and treatment of VZV infections. Herpes 1995;2:21-2.
4. Nathwani D. Effectiveness of Acyclovir for varicella infections in immunocompetent patients. A British perspective. Infect Dis Clin Pract 1995;4:495-585.
5. Fornaro P, et al. Epidemiology and cost analysis of varicella in Italy: results of a sentinel study in the pediatric practice. Italian Sentinel Group on Pediatric Infectious Diseases. Pediatr Infect Dis J 1999;18:414- 19.
6. Balfour HH jr. Varicella: una malattia curabile che vale la pena curare. RIP 1998;24: 1051-52.
7. Balfour HH jr, et al. Acyclovir treatment of varicella in otherwise healty children. J Pediatr 1990;116:633-9.
8. Christophers J, et al. Survey of resistance of herpes simplex virus to Acyclovir in North-west England. Antimicrob Agents Chemother 1998;42:868-72.
9. Jaeggi A, Zurbruegg RP, Aebi C. Complications of varicella in a defined central European population. Arch Dis Child 1998; 79(6):472-7.
10. Suga ES, et al. Effect of oral Acyclovir against primary and secondary viremia in incubation period of Varicella. Arch Dis Child 1993;69:639-43.
11. Balfour, et al. Management of acyclovirresistant herpes simplex and varicella-zoster virus infections. J Acquir Immune Deficit Syndr 1994;7(3):254-60.
12. Homopolymer mutational hot spots mediate herpes simplex virus resistance to acyclovir. J Virol 1997;71(5):3872-8.
13. Ida, et al. Emergence of resistance to acyclovir and pencyclovir in varicella-zoster virus and genetic analysis of acyclovir-resistant variants. Antiviral Res 1999;40(3):155-66.
14. Mah, Kuo, Wei, Tsai, Liu. Screening for acyclovir-resistant herpes simplex virus isolates from clinical samples. Chung Hua Min Kuo Wei Sheng Wu Chi Mien I Hsueh Tsa Chih 30;1:51-4.
15. Nursoy MA, Bakir M, Barlan IB, Basaran MM. The course of chickenpox in asthmatic children receiving inhaled budesonide. Pediatr Infect Dis J 1997;16(1):74-7.
16. Carcao MD, Lau RC, Gupta A, Huerter H, Koren G, King SM. Sequential use of intravenous and oral acyclovir in the therapy of varicella in immunocompromised children. Pediatr Infect Dis J 1998;17(7):626-31.
17. Giaquinto C, Cantarutti C, Sturkenboom M. The natural history of varicella zoster infection in childhood: results from a large prospective study. 38 ICAAC, S. Diego (USA) 1998, Abstract 32H3.