Article Text

PDF

Oral acyclovir in acute cutaneous herpes zoster
  1. Polly Terry,
  2. Susan Buttress
  1. Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL

    Statistics from Altmetric.com

    Report by Polly Terry, Specialist Registrar Search checked by Susan Buttress, Research Physiotherapist

    Clinical scenario

    A 56 year old immunocompetent man presents to the emergency department at 10 pm on a Saturday night with acute shingles. You know acyclovir is effective but wonder how quickly it needs to be started.

    Three part question

    In [immunocompetent adults with acute shingles] is [early acyclovir better than late acyclovir] at [promoting rash healing and minimising the painful period]?

    Search strategy

    Medline 1966–06/00 using the OVID interface. ({exp herpes zoster OR herpes zoster.mp OR shingles} AND {exp acyclovir OR acyclovir.mp OR exp antiviral agents OR antiviral agent$.mp OR anti viral.mp OR anti-viral.mp}) AND maximally sensitive RCT filter LIMIT to human AND english.

    Search outcome

    Altogether 363 papers found of which 360 were irrelevant or of insufficient quality for inclusion, or subject to meta-analysis. The remaining three papers are shown in table 3.

    Table 3

    Comments

    All three meta-analyses used three core papers—but there was enormous variation in selection of the other papers. Thus selection bias may have occurred.

    Clinical bottom line

    Early oral acyclovir (less than 48 hours after onset of rash) will significantly shorten the duration of herpes related pain in shingles.

    Report by Polly Terry, Specialist Registrar Search checked by Susan Buttress, Research Physiotherapist

    References

    View Abstract

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.