Level of Evidence = B
Acyclovir appears to be effective in reducing the number of days with fever among otherwise healthy children with chickenpox, but the clinical importance of this effect remains controversial.
A Cochrane review 1 included 3 studies with a total of 779 subjects. 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.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).
1. Klassen TP, Hartling L. Acyclovir for treating varicella in otherwise healthy children and adolescents. Cochrane Database Syst Rev 2005;(4):CD002980 [Last assessed as up-to-date: 27 September 2008]. [PMID:16235308]
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"Acyclovir for Treating Varicella in Otherwise Healthy Children and Adolescents." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/453836/all/Acyclovir_for_treating_varicella_in_otherwise_healthy_children_and_adolescents.
Acyclovir for treating varicella in otherwise healthy children and adolescents. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/453836/all/Acyclovir_for_treating_varicella_in_otherwise_healthy_children_and_adolescents. Accessed August 25, 2019.
Acyclovir for treating varicella in otherwise healthy children and adolescents. (2019). In Evidence-Based Medicine Guidelines. Available from https://evidence.unboundmedicine.com/evidence/view/EBMG/453836/all/Acyclovir_for_treating_varicella_in_otherwise_healthy_children_and_adolescents
Acyclovir for Treating Varicella in Otherwise Healthy Children and Adolescents [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2019 August 25]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/453836/all/Acyclovir_for_treating_varicella_in_otherwise_healthy_children_and_adolescents.
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