Thursday, February 12, 2015

When to initiate oral Acyclovir in Chicken Pox (varicella zoster)

TIME
  • Most studies carried out/ shows benefit of initiating therapy within the first 24 hours after onset of rash
  • In adults, treatment from 25 to 72 hours after the onset showed no effect on the course of illness. Reduction in other complications (such as varicella pneumonia was not studied)

RECOMMENDATIONS:
  • To initiate within 24hours of symptom
  • Should not be used routinely in otherwise healthy children with varicella due to its modest effect (CDC)

BENEFITS within 24 hours:
  • fewer lesions
  • accelerated healing
  •  shorter duration of fever

HIGH RISK group
  • Older children (>12 years)
  • Secondary household cases (can be more severe)
  • History of chronic cutaneous or cardiopulmonary disorders
  • Taking inhaled or intermittent oral steroid
  • Taking chronic salicylates (higher risk of developing Reye syndrome)

REFERENCES:

1.       www.uptodate.com

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