Acyclovir prophylaxis of varicella in children receiving steroids

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Acyclovir prophylaxis of varicella in children with renal disease receiving

steroids.

Goldstein SL, Somers MJ, Lande MB, Brewer ED, Jabs KL.

Pediatr Nephrol. 2000 Apr;14(4):305-8

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Baylor College of Medicine, Texas Children's Hospital, Houston 77030, USA.

slgoldst@...

Varicella, or chickenpox, is very communicable and has been shown to be

transmitted to nearly 90% of household contacts. Severe varicella infections

with fatal complications have been noted in children receiving

corticosteroids despite the administration of varicella-zoster immune

globulin (VZIG). The use of post-exposure acyclovir prophylaxis in

immunocompetent children exposed to a household contact with varicella has

been shown to decrease the transmission rate of varicella significantly. We

studied the safety and efficacy of acyclovir prophylaxis as an adjunctive

preventive measure in 8 children (10 separate exposures) receiving

corticosteroids for renal disease. Four children (6 separate exposures)

served as controls. No adverse reactions were reported with the acyclovir

prophylaxis. The maximum change between pre- and study serum creatinine

levels was 0.1 mg/dl. None of the 8 patients who received acyclovir

prophylaxis developed chickenpox. One of these 8 patients developed humoral

immunity to varicella despite the absence of clinical infection. One of 4

patients who received VZIG prophylaxis alone developed chickenpox. These

data support the use of acyclovir prophylaxis as an adjunctive measure to

VZIG for the prevention of potentially serious varicella infection in

children receiving steroids.

Publication Types:

a.. Clinical Trial

b.. Randomized Controlled Trial

PMID: 10775074 [PubMed - indexed for MEDLINE]