Huff J C
Department of Dermatology, University of Colorado Health Sciences Center, Denver 80262.
J Am Acad Dermatol. 1988 Jan;18(1 Pt 2):204-6. doi: 10.1016/s0190-9622(88)70029-8.
Intravenous acyclovir is effective for varicella in adults and immunocompromised children, causing more rapid resolution of the illness and fewer complications. Intravenous acyclovir in immunocompromised patients with herpes zoster decreases new lesion formation, decreases acute pain, halts dissemination of the virus, and lessens visceral complications. Intravenous acyclovir may also be effective in zoster encephalitis. Intravenous vidarabine also has a favorable affect on chickenpox and herpes zoster. Topical acyclovir may benefit herpes zoster in immunosuppressed patients by accelerating cutaneous healing. Oral acyclovir appears to be effective in varicella and zoster in immunocompromised patients. It is also effective in otherwise normal patients, but its effect seems less dramatic and the drug must be given early. Neither acyclovir nor vidarabine has been proven clearly to prevent postherpetic neuralgia. Because varicella zoster virus is less sensitive to acyclovir than is herpes simplex, intravenous doses of 500 mg/m2 or 10 mg/kg every 8 hours or oral doses of 800 mg five times a day are recommended. At these doses adequate hydration and urine flow must be maintained, the mental status of the patient must be monitored, and impaired renal function requires regulation of dosage downward.
静脉注射阿昔洛韦对成人水痘和免疫功能低下的儿童有效，可使病情更快缓解，并发症更少。免疫功能低下的带状疱疹患者静脉注射阿昔洛韦可减少新皮损形成，减轻急性疼痛，阻止病毒播散，并减少内脏并发症。静脉注射阿昔洛韦对带状疱疹性脑炎也可能有效。静脉注射阿糖腺苷对水痘和带状疱疹也有良好效果。局部应用阿昔洛韦可能通过加速皮肤愈合而使免疫抑制患者的带状疱疹受益。口服阿昔洛韦对免疫功能低下患者的水痘和带状疱疹似乎有效。对其他情况正常的患者也有效，但其效果似乎不那么显著，且该药物必须早期给药。阿昔洛韦和阿糖腺苷均未被明确证明可预防带状疱疹后神经痛。由于水痘带状疱疹病毒对阿昔洛韦的敏感性低于单纯疱疹病毒，推荐静脉剂量为500mg/m²或10mg/kg，每8小时一次，或口服剂量为800mg，每日5次。在这些剂量下，必须维持充足的水化和尿流，必须监测患者的精神状态，肾功能受损需要下调剂量。
