Drug Can Shorten Chickenpox Illness
Last month the Food and Drug Administration approved acyclovir (Zovirax)--a drug already used for herpes infections--to shorten the duration and severity of chickenpox. Children treated within the first 24 hours after the chickenpox rash appeared had fewer lesions, recovered a day sooner from fever and had less itching than children who weren’t given the drug, according to a study of 815 children published last year in the New England Journal of Medicine.
The five-day dose for chickenpox treatment will cost about $30 to $55, the manufacturer estimates. Will the FDA ruling change the practice habits of pediatricians? Two local doctors comment.
Dr. Harris Stutman, director of pediatric infectious disease, Memorial Miller Childrens Hospital, Long Beach
“This drug does work. There is no question the drug reduces the number of lesions by a third and decreases the time until the child loses the fever by one or two days. The question is ‘So what?’ And that’s an important ‘So what.’ To many people . . . (shortening symptoms by one or two days) doesn’t make any difference.
“There is no evidence that this drug decreases the incidence of complications, which are very rare (to begin with). You have to make a decision based on whether the family needs to get the child better faster. If the family situation would improve, it may be worth using. Also, acyclovir use should be considered more seriously in teens and young adults, because they tend to tolerate chickenpox less well.”
Dr. Wilbert Mason, professor of clinical pediatrics, USC; acting head, division of infectious diseases, Childrens Hospital Los Angeles
“I don’t think we will change our approach. I don’t think the data are strong enough yet to warrant treating every child with acyclovir. For uncomplicated cases of chickenpox, most children are not going to require acyclovir.
“(It might be useful for) certain children more at risk of contracting a severe case of chickenpox, such as teen-agers, those on immunosuppressive therapy or those with underlying immune system disorders. There may be other reasons, socioeconomic ones, for using it. There may be specific circumstances such as other kids in the family (who will lengthen the total sick time when they contract it) or getting a parent back to work more quickly.”
