Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: A New Medicine for Chicken Pox?

Category: Child Care


A new medicine has been released which is effective in the treatment of chicken pox. The medicine is called acyclovir. It is an antiviral medicine which can be taken by mouth, in tablet or liquid form. Numerous studies are out which show that it is effective in decreasing the number of sores on the body as well as the length of time in which a child suffers with fever, itching and the usual misery of chicken pox. Unfortunately, the medicine is only very effective if started within the first 24 hours of skin lesions. In other words, the minute a child begins to show a few pimple like sores, typical of early chicken pox, the medicine must be started for it to have any significant impact. Also, the medicine is fairly expensive in light of the fact that chicken pox is a self-limiting disease and will almost always go away without any treatment other than benadryl for itching and good soap and water washing of the skin.

Nevertheless, many pediatric infectious disease experts who have studied this new medicine are recommending its use, particularly in patients who may be high risk. This might include a patient who has been sick a lot or may be immune-suppressed. If you feel that your child fits this criteria, discuss this option with your doctor.

Older children and adults typically suffer much worse from a case of chicken pox than young children. For this reason, oral acyclovir is recommended primarily for healthy, non-pregnant individuals over age 13. It is also recommended for children over one year of age who are taking aspirin or any type salicylate therapy. This might include a child with juvenile rheumatoid arthritis, as an example.

Another group which is considered for use of oral acyclovir is patients on oral or inhaled corticosteroids. This would include many patients with moderate to severe asthma. The front line treatment for much pediatric asthma today is inhaled corticosteroids to suppress the inflammation which causes the chronic flare-ups of the disease. Patients with asthma should, if possible, stop taking corticosteroids as soon as they are known to be exposed to chicken pox. Other diseases in which children may be on corticosteroids include severe arthritis, severe skin diseases and some kidney diseases.

Other things to consider when using oral acyclovir, as suggested by a recent American Academy of Pediatrics policy statement, include not using the drug for infants under 12 months of age due to lack of sufficient studies. The Academy feels that using acyclovir to treat children who have been infected from a household contact is controversial at this time. Some experts, however, do feel that use of the drug should be considered. Your pediatrician can make the judgement on this by weighing several factors prior to the decision, such as how severe the case was in the previous sibliing, the immune system of the child who has been in contact with the disease, the cost of the medicine, and the timing of the exposure.

Oral acyclovir is not recommended for pregnant adolescents or adults who have uncomplicated chicken pox since the risk to the fetus is not clear at this time. Finally, acyclovir should not be used as a preventive medicine in an otherwise normal healthy child who happens to have been exposed to chicken pox.