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. 1991 Jan;37:92–98.

Topical Acyclovir for Recurrent Herpes Labialis in Primary Care

Critical appraisal

Graham Worrall
PMCID: PMC2145156  PMID: 21234082

Abstract

I reviewed the literature on the treatment of recurrent herpes labialis with topical acyclovir ointment to determine the effectiveness of this treatment for family practice patients. This article discusses the generalizability of the results to family practice. I concluded that the evidence supporting this therapy is weak and that it cannot, in the light of current knowledge, be strongly recommended.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bader C., Crumpacker C. S., Schnipper L. E., Ransil B., Clark J. E., Arndt K., Freedberg I. M. The natural history of recurrent facial-oral infection with herpes simplex virus. J Infect Dis. 1978 Dec;138(6):897–905. doi: 10.1093/infdis/138.6.897. [DOI] [PubMed] [Google Scholar]
  2. Balfour H. H., Jr Acyclovir and other chemotherapy for herpes group viral infections. Annu Rev Med. 1984;35:279–291. doi: 10.1146/annurev.me.35.020184.001431. [DOI] [PubMed] [Google Scholar]
  3. Bilenchi R., Simoni S. Terapia delle infezioni da herpes simplex virus con acyclovir crema. Clin Ter. 1988 Jun 15;125(5):353–358. [PubMed] [Google Scholar]
  4. Bryson Y. J., Dillon M., Lovett M., Acuna G., Taylor S., Cherry J. D., Johnson B. L., Wiesmeier E., Growdon W., Creagh-Kirk T. Treatment of first episodes of genital herpes simplex virus infection with oral acyclovir. A randomized double-blind controlled trial in normal subjects. N Engl J Med. 1983 Apr 21;308(16):916–921. doi: 10.1056/NEJM198304213081602. [DOI] [PubMed] [Google Scholar]
  5. Collins P., Bauer D. J. The activity in vitro against herpes virus of 9-(2-hydroxyethoxymethyl)guanine (acycloguanosine), a new antiviral agent. J Antimicrob Chemother. 1979 Jul;5(4):431–436. doi: 10.1093/jac/5.4.431. [DOI] [PubMed] [Google Scholar]
  6. Corey L., Benedetti J. K., Critchlow C. W., Remington M. R., Winter C. A., Fahnlander A. L., Smith K., Salter D. L., Keeney R. E., Davis L. G. Double-blind controlled trial of topical acyclovir in genital herpes simplex virus infections. Am J Med. 1982 Jul 20;73(1A):326–334. doi: 10.1016/0002-9343(82)90117-6. [DOI] [PubMed] [Google Scholar]
  7. Crumpacker C. S., Schnipper L. E., Zaia J. A., Levin M. J. Growth inhibition by acycloguanosine of herpesviruses isolated from human infections. Antimicrob Agents Chemother. 1979 May;15(5):642–645. doi: 10.1128/aac.15.5.642. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. DerSimonian R., Charette L. J., McPeek B., Mosteller F. Reporting on methods in clinical trials. N Engl J Med. 1982 Jun 3;306(22):1332–1337. doi: 10.1056/NEJM198206033062204. [DOI] [PubMed] [Google Scholar]
  9. Djawari D. Oral Aciclovir-Therapie des Herpes simplex rezidivans. Z Hautkr. 1986 Nov 15;61(22):1629-32, 1637. [PubMed] [Google Scholar]
  10. Fiddian A. P., Ivanyi L. Topical acyclovir in the management of recurrent herpes labialis. Br J Dermatol. 1983 Sep;109(3):321–326. doi: 10.1111/j.1365-2133.1983.tb03548.x. [DOI] [PubMed] [Google Scholar]
  11. Fiddian A. P., Yeo J. M., Stubbings R., Dean D. Successful treatment of herpes labialis with topical acyclovir. Br Med J (Clin Res Ed) 1983 May 28;286(6379):1699–1701. doi: 10.1136/bmj.286.6379.1699. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Furman P. A., McGuirt P. V., Keller P. M., Fyfe J. A., Elion G. B. Inhibition by acyclovir of cell growth and DNA synthesis of cells biochemically transformed with herpesvirus genetic information. Virology. 1980 Apr 30;102(2):420–430. doi: 10.1016/0042-6822(80)90109-9. [DOI] [PubMed] [Google Scholar]
  13. Furman P. A., St Clair M. H., Fyfe J. A., Rideout J. L., Keller P. M., Elion G. B. Inhibition of herpes simplex virus-induced DNA polymerase activity and viral DNA replication by 9-(2-hydroxyethoxymethyl)guanine and its triphosphate. J Virol. 1979 Oct;32(1):72–77. doi: 10.1128/jvi.32.1.72-77.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Gibson J. R., Klaber M. R., Harvey S. G., Tosti A., Jones D., Yeo J. M. Prophylaxis against herpes labialis with acyclovir cream--a placebo-controlled study. Dermatologica. 1986;172(2):104–107. doi: 10.1159/000249307. [DOI] [PubMed] [Google Scholar]
  15. Gibson J. R., Klaber M. R., Harvey S. G., Tosti A., Jones D., Yeo J. M. Prophylaxis against herpes labialis with acyclovir cream--a placebo-controlled study. Dermatologica. 1986;172(2):104–107. doi: 10.1159/000249307. [DOI] [PubMed] [Google Scholar]
  16. Kinghorn G. R. Topical acyclovir in the treatment of recurrent herpes simplex virus infections. Scand J Infect Dis Suppl. 1985;47:58–62. [PubMed] [Google Scholar]
  17. Nilsen A. E., Aasen T., Halsos A. M., Kinge B. R., Tjøtta E. A., Wikström K., Fiddian A. P. Efficacy of oral acyclovir in the treatment of initial and recurrent genital herpes. Lancet. 1982 Sep 11;2(8298):571–573. doi: 10.1016/s0140-6736(82)90658-4. [DOI] [PubMed] [Google Scholar]
  18. Raborn G. W., McGaw W. T., Grace M., Houle L. Herpes labialis treatment with acyclovir 5 per cent ointment. J Can Dent Assoc. 1989 Feb;55(2):135–137. [PubMed] [Google Scholar]
  19. Raborn G. W., McGaw W. T., Grace M., Percy J., Samuels S. Herpes labialis treatment with acyclovir 5% modified aqueous cream: a double-blind randomized trial. Oral Surg Oral Med Oral Pathol. 1989 Jun;67(6):676–679. doi: 10.1016/0030-4220(89)90007-8. [DOI] [PubMed] [Google Scholar]
  20. Raborn G. W., McGaw W. T., Grace M., Percy J. Treatment of herpes labialis with acyclovir. Review of three clinical trials. Am J Med. 1988 Aug 29;85(2A):39–42. [PubMed] [Google Scholar]
  21. Raborn G. W., McGaw W. T., Grace M., Tyrrell L. D., Samuels S. M. Oral acyclovir and herpes labialis: a randomized, double-blind, placebo-controlled study. J Am Dent Assoc. 1987 Jul;115(1):38–42. doi: 10.14219/jada.archive.1987.0211. [DOI] [PubMed] [Google Scholar]
  22. Spruance S. L., McKeough M. B. Evaluation of antiviral treatments for recurrent herpes simplex labialis in the dorsal cutaneous guinea pig model. Antiviral Res. 1988 Aug;9(5):295–313. doi: 10.1016/0166-3542(88)90025-3. [DOI] [PubMed] [Google Scholar]
  23. Spruance S. L., Overall J. C., Jr, Kern E. R., Krueger G. G., Pliam V., Miller W. The natural history of recurrent herpes simplex labialis: implications for antiviral therapy. N Engl J Med. 1977 Jul 14;297(2):69–75. doi: 10.1056/NEJM197707142970201. [DOI] [PubMed] [Google Scholar]
  24. Spruance S. L., Schnipper L. E., Overall J. C., Jr, Kern E. R., Wester B., Modlin J., Wenerstrom G., Burton C., Arndt K. A., Chiu G. L. Treatment of herpes simplex labialis with topical acyclovir in polyethylene glycol. J Infect Dis. 1982 Jul;146(1):85–90. doi: 10.1093/infdis/146.1.85. [DOI] [PubMed] [Google Scholar]
  25. Straus S. E., Seidlin M., Takiff H. Management of mucocutaneous herpes simplex virus infections. Drugs. 1984 Apr;27(4):364–372. doi: 10.2165/00003495-198427040-00004. [DOI] [PubMed] [Google Scholar]
  26. Tugwell P., Bennett K. J., Sackett D. L., Haynes R. B. The measurement iterative loop: a framework for the critical appraisal of need, benefits and costs of health interventions. J Chronic Dis. 1985;38(4):339–351. doi: 10.1016/0021-9681(85)90080-3. [DOI] [PubMed] [Google Scholar]
  27. Van Vloten W. A., Swart R. N., Pot F. Topical acyclovir therapy in patients with recurrent orofacial herpes simplex infections. J Antimicrob Chemother. 1983 Sep;12 (Suppl B):89–93. doi: 10.1093/jac/12.suppl_b.89. [DOI] [PubMed] [Google Scholar]
  28. Vidas I., Rosin-Grget K. Lokalna primjena Zovirax kreme kod recidiva herpes labijalisa. Acta Stomatol Croat. 1987;21(2):147–153. [PubMed] [Google Scholar]
  29. Whitley R. J., Levin M., Barton N., Hershey B. J., Davis G., Keeney R. E., Whelchel J., Diethelm A. G., Kartus P., Soong S. J. Infections caused by herpes simplex virus in the immunocompromised host: natural history and topical acyclovir therapy. J Infect Dis. 1984 Sep;150(3):323–329. doi: 10.1093/infdis/150.3.323. [DOI] [PubMed] [Google Scholar]
  30. Yeo J. M., Fiddian A. P. Acyclovir in the management of herpes labialis. J Antimicrob Chemother. 1983 Sep;12 (Suppl B):95–103. doi: 10.1093/jac/12.suppl_b.95. [DOI] [PubMed] [Google Scholar]

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