A COMPARATIVE OBSERVATIONAL STUDY TO EVALUATE THE EFFICACY OF ACYCLOVIR VERSUS FAMCICLOVIR IN THE MANAGEMENT OF HERPES ZOSTER AT BRIMS TEACHING HOSPITAL, BIDAR

Abstract

BACKGROUND: Herpes zoster known as shingles is a viral disease caused by reactivation of varicella zoster virus which remains dormant in the ganglia by a previous varicella infection.
Comparison of efficacy of acyclovir v/s famciclovir helps clinician to choose a better anti-viral drug against herpes zoster for early healing of rash and relief of associated neuralgia and improve the compliance of he patient. AIM / OBJECTIVES: To evaluate the efficacy of acyclovir versus famciclovir in the management of herpes zoster at brims teaching hospital, bidar. MATERIALS AND METHODS: Relevant data was taken from patients with herpes zoster who presented within 72 hrs of onset of rash a total of 150 patients were enrolled in the study. They were randomized into two groups of 75 patients each group A-75 patients were given acyclovir 800 mg 5 times a day for 7 days. Group B-75 patients were given famciclovir 500 mg 3 times a day for 5 days, patients were called for follow up at 1st, 2nd, 3rd & 4th weeks. RESULTS: Healing of rash was quicker in famciclovir group with 53% healing by day 15 and 100% by day 29. In acyclovir group healing was 30% by day 15 and 73% by day 29. healing was slower and incomplete in acyclovir group compared to famciclovir group. When pain scores (measured by VAS) between the groups were compared a significant reduction was observed in famciclovir group (p<0.005). CONCLUSION: The result of the present study shows that administration of famciclovir 500 mg TID is effective and safe in management of herpes zoster. Furthermore, famciclovir has the convenience of 3 times a day dose compared to acyclovir which is 5 times daily dosing. This ensures better patient compliance and makes famciclovir a good drug for the management of herpes zoster. The reduction of pain was better with famciclovir than with acyclovir. Other than resolution of healing of rash which is faster with famciclovir than with acyclovir there are no differences in outcome of abnormal sensation and adverse effects with both the drugs.