Volume 5, Issue 3 ( Journal of Clinical and Basic Research (JCBR) 2021)                   jcbr 2021, 5(3): 25-32 | Back to browse issues page

Ethics code: IR.GOUMS.REC.1399.345


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Parhiz J, Rahafard S, Mazidi A. Effect of Oral Acyclovir on Hospitalized Children with Infectious Mononucleosis: A Double-blind Clinical Trial. jcbr 2021; 5 (3) :25-32
URL: http://jcbr.goums.ac.ir/article-1-311-en.html
1- Neonatal & Children's Health Research Center , Golestan University of Medical Sciences , Gorgan , Iran
2- Neonatal & Children's Health Research Center , Golestan University of Medical Sciences , Gorgan , Iran , dr.rahafard@gmail.com
Abstract:   (2254 Views)
Background and objectives: Infectious mononucleosis is a disease mainly caused by Epstein-Barr virus. The disease is most frequently observed in children. Acyclovir is a nucleoside analogue with high in-vitro antiviral activity. The present study was performed to evaluate the therapeutic effect of oral acyclovir on hospitalized children with infectious mononucleosis.
Methods: This randomized double-blind clinical trial was performed on 48 patients with infectious mononucleosis who were randomly divided into an intervention (n=22) and a control (n=26) group. The intervention group received 80 mg/kg/day oral acyclovir q.i.d. for five days and the control group received placebo (Starch capsule, Barij Essence). Clinical symptoms, test results, drug side effects and demographic information of the patients were recorded in a checklist. Data were analyzed using SPSS 18. Descriptive statistics including mean and standard deviation were used to describe data. The chi-square and Mann-Whitney tests were used for comparison of data. All analysis was carried out at significance of 0.05.
Results: The mean age of patients in the treatment and control groups was 5.67± 2.82 and 6.94± 3.43 years, respectively (p=0.50). The symptoms of infectious mononucleosis e.g. fever, exudative erythema, tonsillitis, lymphadenopathy, tenderness, hepatomegaly and splenomegaly did not differ significantly between the two groups (p>0.05). In addition, the mean duration of hospitalization in the intervention and control groups was 4.23 ± 1.71 and 5.85 ± 7.27 days, respectively (p=0.65).
Conclusion: The use of acyclovir-based regimens in the treatment of patients with infectious mononucleosis still depends on clinical suspicion and the experience of the treating physician, and its routine use is not recommended.
Full-Text [PDF 1085 kb]   (727 Downloads) |   |   Full-Text (HTML)  (520 Views)  
Article Type: Research | Subject: Medicine

References
1. Basheer A, Iqbal N, Mookkappan S, Anitha P, Nair S, Kanungo R, et al. Clinical and laboratory characteristics of dengue-orientia tsutsugamushi co-infection from a tertiary care center in south india. Mediterranean journal of hematology and infectious diseases. 2016;8(1). [View at Publisher] [DOI] [PMID] [PMCID] [Google Scholar]
2. Topp SK, Rosenfeldt V, Vestergaard H, Christiansen CB, Von Linstow M-L. Clinical characteristics and laboratory findings in Danish children hospitalized with primary Epstein-Barr virus infection. Infectious Diseases. 2015;47(12):908-14. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Rodriguez-Zuniga M, Torres N, Garcia-Perdomo H. Effectiveness of acyclovir in the treatment of pityriasis rosea. A systematic review and meta-analysis. Anais brasileiros de dermatologia. 2018;93(5):686-95. [View at Publisher] [DOI] [PMID] [PMCID]
4. Nandi M, Hazra A, Das MK, Bhattacharya S, Sarkar UK. Infectious mononucleosis due to epstein-barr virus infection in children: A profile from eastern India. Medical Journal of Dr DY Patil University. 2017;10(5):438. [View at Publisher] [DOI] [Google Scholar]
5. Hellwig T, Jude K, Meyer B. Management options for infectious mononucleosis. US Pharm. 2013;38(5):38-41. [View at Publisher] [Google Scholar]
6. Hashemian H, Karambin M, Ghorbandoust S. Demographic, Clinical, and Laboratory Characteristics of Patients with Infectious Mononucleosis. Journal of Guilan University of Medical Sciences. 2016;25(98):17-23. [View at Publisher] [Google Scholar]
7. Rezk E, Nofal YH, Hamzeh A, Aboujaib MF, AlKheder MA, Al Hammad MF. Steroids for symptom control in infectious mononucleosis. Cochrane Database of Systematic Reviews. 2015(11). [View at Publisher] [DOI] [PMID] [Google Scholar]
8. Cappuccino JG, Welsh CT. Microbiology: A laboratory manual: Pearson Education; 2017. [View at Publisher] [Google Scholar]
9. De Paor M, O'Brien K, Fahey T, Smith SM. Antiviral agents for infectious mononucleosis (glandular fever). Cochrane Database of Systematic Reviews. 2016(12). [View at Publisher] [DOI] [PubMed] [Google Scholar]
10. Yager JE, Magaret AS, Kuntz SR, Selke S, Huang M-L, Corey L, et al. Valganciclovir for the suppression of Epstein-Barr virus replication. The Journal of infectious diseases. 2017;216(2):198-202. [View at Publisher] [DOI] [PubMed] [Google Scholar]
11. Tynell E, Aurelius E, Brandell A, Julander I, Wood M, Yao Q-y, et al. Acyclovir and prednisolone treatment of acute infectious mononucleosis: a multicenter, double-blind, placebo-controlled study. Journal of Infectious Diseases. 1996;174(2):324-31. [View at Publisher] [DOI] [PubMed] [Google Scholar]
12. Kaushal V, Sonune M, Gupta S. P2. 46 Evaluation of effectiveness and safety of acyclovir 1 gm once a day single oral dose for 5 days for treatment of genital herpes. BMJ Publishing Group Ltd; 2017. [View at Publisher] [DOI] [Google Scholar]
13. Abdalla S, Briand C, Oualha M, Bendavid M, Béranger A, Benaboud S, et al. Population pharmacokinetics of intravenous and oral acyclovir and oral valacyclovir in pediatric population to optimize dosing regimens. Antimicrobial Agents and Chemotherapy. 2020;64(12):e01426-20. [View at Publisher] [DOI] [PubMed] [Google Scholar]
14. Drosu NC. Understanding the mechanism of antiretroviral nucleoside analogs as inhibitors of Epstein-Barr virus lytic DNA replication: Massachusetts Institute of Technology; 2020. [View at Publisher] [Google Scholar]
15. Andersson J, Britton S, Ernberg I, Andersson U, Henle W, Sköldenberg B, et al. Effect of acyclovir on infectious mononucleosis: a double-blind, placebo-controlled study. Journal of Infectious Diseases. 1986;153(2):283-90. [View at Publisher] [DOI] [PubMed] [Google Scholar]
16. van der Horst C, Joncas J, Ahronheim G, Gustafson N, Stein G, Gurwith M, et al. Lack of effect of peroral acyclovir for the treatment of acute infectious mononucleosis. Journal of Infectious Diseases. 1991;164(4):788-92. [View at Publisher] [DOI] [PubMed] [Google Scholar]
17. Usami O, Saitoh H, Ashino Y, Hattori T. Acyclovir reduces the duration of fever in patients with infectious mononucleosis-like illness. The Tohoku journal of experimental medicine. 2013;229(2):137-42. [View at Publisher] [DOI] [PubMed] [Google Scholar]
18. Vezina HE, Balfour Jr HH, Weller DR, Anderson BJ, Brundage RC. Valacyclovir Pharmacokinetics and Exploratory Pharmacodynamics in Young Adults With Epstein‐Barr Virus Infectious Mononucleosis. The Journal of Clinical Pharmacology. 2010;50(7):734-42. [View at Publisher] [DOI] [PubMed] [Google Scholar]
19. Yao Y, Duan H-m, Yan H-m, Zhen X-f, Pan Y-c, Yao Y, et al. Clinically controlled study on children's infectious mononucleosis treated by Chinese medicine. Chinese journal of integrative medicine. 2009;15(5):347-52. [View at Publisher] [DOI] [PubMed] [Google Scholar]
20. Gao L-W, Xie Z-D, Liu Y-Y, Wang Y, Shen K-L. Epidemiologic and clinical characteristics of infectious mononucleosis associated with Epstein-Barr virus infection in children in Beijing, China. World Journal of Pediatrics. 2011;7(1):45-9. [View at Publisher] [DOI] [PubMed] [Google Scholar]
21. Son KH, Shin MY. Clinical features of Epstein-Barr virus-associated infectious mononucleosis in hospitalized Korean children. Korean journal of pediatrics. 2011;54(10):409. [View at Publisher] [DOI] [PubMed] [Google Scholar]
22. Andersson J, Sköldenberg B, Henle W, Giesecke J, Örtqvist A, Julander I, et al. Acyclovir treatment in infectious mononucleosis: a clinical and virological study. Infection. 1987;15(1):S14-S20. [View at Publisher] [DOI] [PubMed] [Google Scholar]
23. Smith JP, Weller S, Johnson B, Nicotera J, Luther JM, Haas DW. Pharmacokinetics of acyclovir and its metabolites in cerebrospinal fluid and systemic circulation after administration of high-dose valacyclovir in subjects with normal and impaired renal function. Antimicrobial agents and chemotherapy. 2010;54(3):1146. [View at Publisher] [DOI] [PubMed] [Google Scholar]
24. Bacon TH, Boyd MR. Activity of penciclovir against Epstein-Barr virus. Antimicrobial agents and chemotherapy. 1995;39(7):1599. [View at Publisher] [DOI] [PubMed] [Google Scholar]
25. Ishii T, Sasaki Y, Maeda T, Komatsu F, Suzuki T, Urita Y. Clinical differentiation of infectious mononucleosis that is caused by Epstein-Barr virus or cytomegalovirus: A single-center case-control study in Japan. Journal of Infection and Chemotherapy. 2019;25(6):431-6. [View at Publisher] [DOI] [PubMed] [Google Scholar]
26. Cantan B, Luyt C-E, Martin-Loeches I, editors. Serious Infections in the ICU: Evolving Concepts in Management and Prevention: Influenza Infections and Emergent Viral Infections in Intensive Care Unit. Seminars in respiratory and critical care medicine; 2019: Thieme Medical Publishers. [View at Publisher] [DOI] [PubMed] [Google Scholar]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Journal of Clinical and Basic Research

Designed & Developed by : Yektaweb

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0).