Acyclovir can reduce the number of days with fever in otherwise healthy children with chickenpox


By www.ncbi.nlm.nih.gov

Chickenpox (varicella) is caused by a virus. It begins with a fever, followed by a rash of red pimples which become itchy sores that form scabs. Chickenpox usually affects children from one to 14 years. In young babies, adults or people with impaired immune system, chickenpox is more severe. Treatments include lotions to relieve itchiness, paracetamol (acetaminophen) for fever and the antiviral drug acyclovir. The review of trials found that acyclovir reduces the number of days of fever from chickenpox in otherwise healthy children, usually without adverse effects. It is not clear whether it improves sores and itching.

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Background: Acyclovir has the potential to shorten the course of illness which may result in reduced costs and morbidity associated with chickenpox.

Objectives: To examine the evidence evaluating the efficacy of acyclovir in alleviating symptoms of chickenpox and shortening the duration of illness.

To examine complications of chickenpox and adverse effects associated with acyclovir as reported in the relevant trials.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2008, issue 3) which contains the Acute Respiratory Infections Group's Specialized Register, MEDLINE (1950 to Septemer Week 3, 2008), and EMBASE (1974 to September 2008). The reference lists of all relevant articles were reviewed.

Selection criteria: Randomized controlled trials that evaluated otherwise healthy children zero to 18 years of age, with chickenpox.

Data collection and analysis: Two review authors independently reviewed the studies for eligibility. Two review authors independently assessed methodological quality of the relevant studies using the Jadad scale and allocation concealment. Differences were resolved by consensus. Data were extracted by one review author using a structured form and checked by a second.

Continuous data were converted to the weighted mean difference (WMD). Weighted mean differences were combined into an overall estimate using random effects. There were too few studies to consider exploring statistical heterogeneity between studies (i.e., differences in reported effects), formally, or to assess for publication bias.

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Main results: Three studies were included. Study quality was three (n = 2) and four (n = 1) on the Jadad scale. Acyclovir was associated with a reduction in the number of days with fever (-1.1 days, 95% CI -1.3 to -0.9) and in reducing the maximum number of lesions (-76 lesions, -145 to -8). Results were less supportive with respect to the number of days to no new lesions and the number of days to the relief of itching. There were no clinically important differences between acyclovir and placebo with respect to complications associated with chickenpox or adverse effects associated with the treatment.

Authors' conclusions: Acyclovir appears to be effective in reducing the number of days with fever and the maximum number of lesions among otherwise healthy children with chickenpox. The results were less convincing with respect to the number of days to no new lesions and relief of itchiness. The clinical importance of acyclovir treatment in otherwise healthy children remains uncertain.

Source: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0011728/

Saturday, May 30, 2026

Misoprostol (Cytotec) - Acid Reflux - Patient guide - Quick tips

Misoprostol pricing should be evaluated as part of total ulcer-prevention strategy in chronic NSAID users. Drug may be available as generic, but real cost impact depends on dosing frequency, adherence, side-effect management, and need for follow-up. Patients often compare only tablet price, yet total expense includes clinic reassessment for intolerance, hydration management if diarrhea persists, and potential emergency care if warning signs are missed. Insurance plans may differ on quantity limits and preferred pharmacy pathways. Multi-dose daily schedules can increase refill frequency, so practical access planning is important. These realities make cytotec-misoprostol pricing options part of shared decision-making. If side effects reduce adherence, cheaper price alone may not deliver effective ulcer protection. Clinicians should reassess whether ongoing NSAID exposure remains necessary. Reducing offending NSAID burden can lower both medication costs and complication risk. Pharmacists can compare cash, insurance, and discount pathways and help patients choose refill cadence that matches prescribed schedule. Families can support continuity by setting refill reminders and tracking hydration and symptom trends during early treatment weeks. When affordability barriers appear, care team can review alternate gastroprotective pathways rather than leaving patient to self-modify dosing. For broader guidance on sustainable ulcer-prevention planning and reflux-care access, patients can review acid reflux planning resources before follow-up visits. Cost discussions should include practical adherence barriers such as work schedules, meal timing, and travel, because frequent daily dosing can become difficult without planning. Patients who miss doses repeatedly may lose protective benefit even when prescription is technically affordable. Early follow-up focused on both tolerability and refill access can prevent drop-off in first month. When coverage changes during year, patients should verify formulary status quickly to avoid sudden interruptions. One-week refill buffer is useful safeguard against authorization delays and pharmacy stock issues. Clear budgeting conversations improve long-term protection and reduce avoidable complications.

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