A retrospective and an observational study with acyclovir

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Abstract
Retrospective analysis: This open controlled non‐randomized study was carried out to investigate the influence of intravenous acyclovir (ACV) on the incidence of post‐herpetic neuralgia (PHN). Twelve women and 11 men (mean age 52 years, range 19–89) received ACV 5 mg/kg every 8 hours) for 10 days (I). Twenty‐seven untreated patients (mean age 62 years, range 20–89) were taken as a control group (II). Six to 24 months after the onset of herpes zoster (shingles) the patients were reexamined. The analysis revealed a significantly lower incidence of both general pain and severe pain (P < 0.05, X2 = 5.55 and 4.39) for (I) compared to (II). For 21 patients who were treated for a period of 10 days, the significance level was 1% (X2 = 7.82 and 8.62). Observational study: Fifteen thousand eight hundred and thirty‐one non‐hospitalized patients with shingles (mean age 55.2 years) received oral ACV (800 mg five times daily) for 7 days. At the onset of therapy, 15,420 patients (97.6%) reported pain (severe 42.6%, moderate 43.1%, mild 14.3%). The pain during treatment was documented by the patients (n = 5,728) in a diary and transferred to a scoring system (0 = none, 1 = mild, 2 = moderate, 3 = severe). From day 1 to day 7 there was a decrease in the pain score level from 2.3 to 0.9. Three months after the onset of herpes zoster, 2,519 of 14,858 patients (16.95%) reported pain; 311 patients (2.1%) complained of continuous pain, typical for PHN. The conclusion is that the incidence of PHN can be reduced if ACV is given for 7–10 days.