Treatment of recurrent herpes simplex labialis with oral acyclovir

Article Abstract:

Herpes simplex infections can cause cold sores, and many people are prone to repeated bouts of the disease. It has been difficult to lessen the severity or length of such episodes in people with normal immune systems, probably due to rapid development of the sores, a strong immune defense which blocks further progression of the sore, and poor delivery of drug treatments to the inner skin layers. Previous studies of drug treatments have yielded inconsistent results, such as variations in which stages of sore development were shortened, duration of pain, and size of lesions (sores). The effects of acyclovir (ACV) on a group of 174 people who were prone to recurring cold sores were studied. It was more difficult to isolate virus from the lesions of people who were treated with ACV. The number and size of lesions did not differ, but among people who took ACV at the earliest stage of lesion development, the duration of pain was reduced by 36 percent. In addition, the healing process was quicker in that the amount of time the sore was covered by a hard crust (normally the longest stage of the eight stages of normal lesion development) was decreased by 27 percent. However, some patients had milder lesions, which did not undergo all eight stages of lesion development, and they did not obtain this benefit of ACV. Thus, ACV treatment benefits best those people who take the drug at earliest times of sore recurrence, and those whose lesions tend to be more severe. (Consumer Summary produced by Reliance Medical Information, Inc.)

Acyclovir

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Early application of topical 15% Idoxuridine in dimethyl sulfoxide shortens the course of herpes simplex labialis: a multicenter placebo-controlled trial

Article Abstract:

Herpes simplex infections cause cold sores, painful sores around the lips that tend to recur. Drug therapy for cold sores has had limited success. Several studies have reached opposite conclusions as to whether idoxuridine (IDU) is effective in treating the condition. Previous studies have shown that IDU, given in a special penetrating solvent (DMSO; dimethyl sulfoxide) was the most effective among 20 drugs used to treat herpes simplex in guinea pigs. The effect of IDU, given as a 15 percent solution in DMSO, on cold sores in 301 people was studied. Among all the people treated, the duration of pain and amount of healing time was decreased by 35 and 21 percent, respectively. Among those who began treatment very early after onset of symptoms, these decreased by 42 and 38 percent. Among the patients with severe cold sores (namely, those that progressed through eight stages of development), an even greater benefit in reduction of duration of pain (49 percent decrease), while healing time was reduced by 23 percent. Few side effects, notably stinging and nausea, were noted, and these were due to the vehicle, DMSO. Three patients discontinued treatment because of this. Thus, IDU delivered in this form appears to be useful treatment for a disorder for which few effective treatments are available. (Consumer Summary produced by Reliance Medical Information, Inc.)

Dosage and administration, Idoxuridine

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Penciclovir cream for the treatment of herpes simplex labialis: a randomized, multicenter, double-blind, placebo-controlled trial

Article Abstract:

Penciclovir cream applied to herpes simplex lesions appears to heal the sores faster. Of 1,573 patients given cream to apply at home when they had an outbreak of herpes simplex, 782 had penciclovir cream and 791 had a placebo cream. Penciclovir healed the lesions a little faster and also reduced pain and virus shedding. Penciclovir worked when it was applied at the beginning of the outbreak and also when it was applied during the outbreak. There were no serious adverse effects from the medication.

Antiviral agents

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