Acyclovir treatment of varicella in otherwise healthy children

Henry H Balfour, Joan M. Kelly, Carmen S. Suarez, Ralph C. Heussner, Janet A. Englund, Deborah D. Crane, Paul V. McGuirt, Anne F. Clemmer, Dorothee M. Aeppli

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158 Scopus citations


Study objective: To determine whether acyclovir administered orally affects the duration and severity of varicella in otherwise normal children. Design: Randomized, placebo-controlled, double-blind trial. Setting: Patients' residence and university hospital clinic. Patients: One hundred five children between 5 and 16 years of age with laboratory-confirmed varicella entered the study. Of the 102 who were included in the final analysis, 50 received acyclovir and 52 received placebo. Interventions: Placebo or acyclovir was given orally four times daily, for 5 to 7 days. The acyclovir dose was adjusted as follows: 5 to 7 years of age, 20 mg/kg; 7 to 12 years, 15 mg/kg; and 12 to 16 years, 10 mg/kg. Measurements and main results: Acyclovir recipients, compared with the placebo group, defervesced sooner (median, 1 day vs 2 days; p=0.001), experienced onset of cutaneous healing sooner, as reflected by a decrease in number of lesions (median, 3 days vs 2 days; p=0.002), and had fewer skin lesions (median, 500 vs 336; p=0.02). Acyclovir did not significantly change the rate of complications of varicella (10% in the acyclovir group vs 13.5% among placebo subjects). Adverse drug effects were not observed. Acyclovir recipients had lower geometric mean serum antibody titers to varicella-zoster virus than their placebo counterparts 4 weeks after the onset of illness, but antibody titers in both groups were similar 1 year later. Conclusions: These results provide evidence that acyclovir is useful and well tolerated for treatment of varicella in otherwise healthy children.

Original languageEnglish (US)
Pages (from-to)633-639
Number of pages7
JournalThe Journal of pediatrics
Issue number4
StatePublished - Apr 1990

Bibliographical note

Funding Information:
In the United States approximately 3.5 million persons contract varicella each year, resulting in the hospitalization of at least 4000 previously healthy children. 1 Varicella vaccine 2 could improve this situation, but some primary and Supported by grants from the Burroughs Wellcome Company and the Minnesota Medical Foundation. Submitted for publication Oct. '26, 1989; accepted Dec. 1, 1989. Reprint requests: Henry H. Balfour, Jr., MD, Box 43'7 UMHC, University of Minnesota Health Sciences Center, Minneapolis, MN 55455. *Now at Baylor College of Medicine, Houston, Texas.


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