Therapy of Herpes zoster: Comparison of the Efficacy of New and Old Antivirals

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Giuliano Piccoliori

QuestionIn case of herpes zoster (shingles) and indication for an antiviral therapy, are the newer antivirals (famciclovir, valaciclovir, brivudin) preferable to the old ones (aciclovir)?AnswerCurrent best evidence is partially contradictory and does not justify a clear recommendation to use the newer antivirals instead of aciclovir as first line treatment of herpes zoster (shingles). It is quite certain that famciclovir, valaciclovir and brivudin have a similar effect as aciclovir on skin lesions and acute pain. It is not clear whether any antiviral has any effect regarding the prevention of postherpetic neuralgia. The newer substances may be preferred due to better bioavailability and once daily dosing as this may improve patient compliance.

(State: 14.05.2018)

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