Acyclovir for treating primary herpetic gingivostomatitis

Evidence Summaries

Level of Evidence = C
Acyclovir may be an effective treatment in reducing the number of oral lesions and in alleviating difficulties in eating and drinking in children with primary herpetic gingivostomatitis.

A Cochrane review 1 [withdrawn from The Cochrane Library Issue 1, 2016] included 2 studies with a total of 92 children with clinical gingivostomatitis, in the majority verified with a positive viral culture for herpes simplex. The larger trial (n=72) showed better results in the acyclovir group compared to the placebo group in children < 6 years of age in reducing the number of individuals with oral lesions (RR 0.10, 95% CI 0.02 to 0.38), new extraoral lesions (RR 0.04, 95% CI 0.00 to 0.65), difficulty in eating (RR 0.14, 95% CI 0.03 to 0.58), and drinking difficulties (RR 0.11, 95% CI 0.01 to 0.83) after 8 days of treatment. Three patients from the placebo group were admitted to hospital for rehydration. The second study failed to report several methodological items and was inconsistent in its reporting of the outcomes measurement. None of the included studies reported any significant side effects.

Comment: The quality of evidence is downgraded by several limitations in study quality and by imprecise results (limited study size for each comparison).


1. Nasser M, Fedorowicz Z, Khoshnevisan MH et al. WITHDRAWN: Acyclovir for treating primary herpetic gingivostomatitis. Cochrane Database Syst Rev 2016;(1):CD006700 [withdrawn from The Cochrane Library].  [PMID:26784280].

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