Abstract
Objective To test the hypothesis that treatment with oral acyclovir reduces the incidence of Post-herpetic neuralgia.
Data sources A medline search of English language papers from 1966–1996 (MeSH terms ‘acyclovir’, ‘herpes zoster’ and ‘randomised clinical trials’). Additional references were identified from references retrieved and the National Institute of Heath database of funded studies and Cochrane database of Randomised Controlled trials were searched for published and unpublished data.
Study selection 30 studies were originally identifies and articles were assessed blind by two of the authors using predefined criteria. 25 were excluded because of use of intravenous or topical acyclovir (7), duplicate data (8) lack of placebo group or randomisation (4) sub-optimal oral dosage (5) and late commencement of treatment (1).
Data extraction and synthesis Data from the five studies was pooled and the odds ratios calculated for the incidence of ‘any pain’ at 6 months.
Results The odds ratio for incidence of any pain at six months was 0.54 (95% CI 0.36–0.81). This translates to a number needed to treat to prevent one case of 6.3.
Conclusions This meta-analysis suggests that patients treated within 72 hours of rash onset may experience a 46% reduction in the incidence of pain in the distribution of the rash at 6 months in immunocompetent adults.
Jackson J L, Gibbons R, Meyer G, Inouyer L. The effect of treating Herpes zoster with oral acyclovir in preventing post herpetic neuralgia. A meta-analysis. Arch Intern Med 1997; 157: 909–912
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Address: Jeffery J. Jackson, c/o Col. Lester Reid, Department of Medicine, Madigan Army Medical Centre, Tacoma, WA 98431, USA
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Barkvoll, P. Oral acyclovir in first 72 hours may reduce pain of post herpetic neuralgia. Evid Based Dent 1, 16 (1998). https://doi.org/10.1038/sj.ebd.6490010
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DOI: https://doi.org/10.1038/sj.ebd.6490010