This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wald, A Articles by Corey, L Search for Related Content PubMed PubMed Citation Articles by Wald, A Articles by Corey, L

 Previous Article  |  Next Article 

Antimicrob Agents Chemother. 1994 February; 38(2): 174-176

A randomized, double-blind, comparative trial comparing high- and standard-dose oral acyclovir for first-episode genital herpes infections.

A Wald, J Benedetti, G Davis, M Remington, C Winter and L Corey

Department of Laboratory Medicine, University of Washington, Seattle 98144.

ABSTRACT

Orally administered acyclovir ameliorates the clinical course and decreases the duration of viral shedding in patients with first-episode genital herpes infections. We investigated in a randomized, double-blind, comparative trial whether a higher (4 g) than standard (1 g) daily dose of oral acyclovir results in greater clinical benefit and influences the time to first recurrence. A total of 139 patients with first-episode genital herpes were randomized to receive orally 4 or 1 g of acyclovir daily. A total of 52 subjects were excluded from the efficacy analysis because most had recurrent disease. Of 87 eligible subjects, 28 (32%) had primary herpes simplex virus type 1 (HSV-1) infections, 48 (55%) had primary HSV-2 infections, and 11 (13%) had nonprimary HSV-2 infections. We did not find any statistically significant differences in the duration of symptoms or viral shedding between the two dose groups, nor did the median time to first recurrence differ between the two groups. Initiation of therapy with either dose within the first 3 days of the appearance of symptoms shortened the duration of the first episode. Adverse gastrointestinal effects developed in 8% of subjects receiving the higher dose, whereas no adverse reactions were observed among those receiving the standard dose (P = 0.10). We conclude that, in comparison with standard therapy, higher-dose oral acyclovir does not result in additional clinical benefit or modify the time to first recurrence. The present study may have implications for the development and efficacy of congeners of acyclovir which provide higher levels in blood than the standard dose of acyclovir.

---

Antimicrob Agents Chemother. 1994 February; 38(2): 174-176

This article has been cited by other articles:

• Farhi, D., Wendling, J., Molinari, E., Raynal, J., Carcelain, G., Morand, P., Avril, M.-F., Frances, C., Rozenberg, F., Pelisse, M., Dupin, N. (2009). Non-Sexually Related Acute Genital Ulcers in 13 Pubertal Girls: A Clinical and Microbiological Study. Arch Dermatol 145: 38-45 [Abstract] [Full Text]  
• Cernik, C., Gallina, K., Brodell, R. T. (2008). The Treatment of Herpes Simplex Infections: An Evidence-Based Review. Arch Intern Med 168: 1137-1144 [Abstract] [Full Text]  
• Wald, A (2006). Genital HSV-1 infections.. Sex. Transm. Infect. 82: 189-190 [Full Text]  
• Patrick, D M, Rosenthal, S L, Stanberry, L R, Hurst, C, Ebel, C (2004). Patient satisfaction with care for genital herpes: insights from a global survey. Sex. Transm. Infect. 80: 192-197 [Abstract] [Full Text]  
• Fisman, D N, Hook, E W III, Goldie, S J (2003). Estimating the costs and benefits of screening monogamous, heterosexual couples for unrecognised infection with herpes simplex virus type 2. Sex. Transm. Infect. 79: 45-52 [Abstract] [Full Text]  
• Schacker, T., Ryncarz, A. J., Goddard, J., Diem, K., Shaughnessy, M., Corey, L. (1998). Frequent Recovery of HIV-1 From Genital Herpes Simplex Virus Lesions in HIV-1-Infected Men. JAMA 280: 61-66 [Abstract] [Full Text]  
• Spruance, S. L., Tyring, S. K., DeGregorio, B., Miller, C., Beutner, K. (1996). A Large-Scale, Placebo-Controlled, Dose-Ranging Trial of Peroral Valaciclovir for Episodic Treatment of Recurrent Herpes Genitalis. Arch Intern Med 156: 1729-1735 [Abstract]  
• Oliver, L., Wald, A., Kim, M., Zeh, J., Selke, S., Ashley, R., Corey, L. (1995). Seroprevalence of Herpes Simplex Virus Infections in a Family Medicine Clinic. Arch Fam Med 4: 228-232 [Abstract]