Summary
Both aciclovir and brivudin are effective in the treatment of immunocompromised children with varicella-zoster virus infection. To determine which drug is preferable, a prospective randomized trial aciclovir vs. brivudin was conducted. Forty-three immunocompromised children were randomly assigned to receive aciclovir intravenously at a dose of 1,500 mg/m|22|0/d and brivudin orally at a dose of 15 mg/kg/d, respectively. Twenty-two patients were treated with aciclovir and 21 with brivudin. In all children the general status improved within two days. The eruption of new lesions stopped within one to five days, fever stopped within one to nine days, complete remission occurred within five to six days after introduction of the virustatic therapy. There was no difference in therapeutic efficacy between aciclovir and brivudin. Two children in each group did not respond to the medication. No myelo-, hepato- and nephrotoxic side effects due to aciclovir or brivudin were observed. All obviously immunocompromised children with varicella or zoster may be treated with aciclovir or brivudin.
Zusammenfassung
Aciclovir und Brivudin sind hochwirksame Medikamente für die Behandlung von immuninsuffizienten Kindern mit Varicella-Zoster-Virus-Krankheiten. In einer prospektiven randomisierten Studie Aciclovir versus Brivudin an immundefizienten Kindern erfolgte eine klinische Prüfung mit der Frage, inwieweit eines der beiden Virustatika bevorzugt angewendet werden kann. Aciclovir wurde als Kurzinfusion in einer Dosierung von 1500 mg/m2 KOF/d und Brivudin per os in einer Dosierung von 15 mg/kg/d verordnet. 43 Kinder erhielten eine antivirale Therapie, 22 mit Aciclovir und 21 mit Brivudin. Nach Therapiebeginn besserte sich der Allgemeinzustand der Patienten innerhalb von zwei Tagen. Die Entwicklung der Effloreszenzen sistierte innerhalb von ein bis fünf Tagen. Die Entfieberung trat nach ein bis neun Tagen ein, und in der Regel war die Varicella-Zoster- Virus-Infektion nach fünf bis sechs Tagen abgeklungen. Unterschiede in der therapeutischen Wirksamkeit zwischen beiden Virustatika wurden nicht registriert. In jeder Behandlungsgruppe gab es jeweils zwei Therapieversager. Myelo-, hepato- und nephrotoxische Nebenwirkungen im Zusammenhang mit der virustatischen Behandlung traten nicht auf. Deshalb kann zusammenfassend festgestellt werden, daß immuninsuffiziente Kinder mit Varizellen oder Zoster gleichermaßen mit Aciclovir oder Brivudin behandelt werden können.
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Heidl, M., Scholz, H., Dörffel, W. et al. Antiviral therapy of varicella-zoster virus infection in immunocompromised children — A prospective randomized study of aciclovir versus brivudin. Infection 19, 401–405 (1991). https://doi.org/10.1007/BF01726449
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DOI: https://doi.org/10.1007/BF01726449