MMWR Morb Mortal Wkly Rep. 1993 Oct 22;42(41):806-9.
Pregnancy outcomes following systemic prenatal acyclovir exposure--June 1, 1984-June 30, 1993.

[No authors listed]

Herpes infections are common among women of reproductive age (i.e., aged 15-44 years). Acyclovir (Zovirax), an antiviral drug effective in the treatment of herpes simplex infection, was approved by the Food and Drug Administration (FDA) in 1984. Since its approval, the effects of acyclovir on human pregnancies have not been determined. However, inadvertent pregnancy exposures to acyclovir were expected to occur among women in whom treatment had been indicated for preexisting herpes simplex infections. Some physicians have reported intentional use of acyclovir during pregnancy for treatment of life-threatening herpes simplex infection. To assess the outcomes of pregnancies exposed to acyclovir, the Acyclovir in Pregnancy Registry was established on June 1, 1984, by the manufacturer, in collaboration with CDC. This report summarizes data on pregnancies reported to the registry through June 30, 1993.

Online pharmacy ref source - acyclovir: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8413168&dopt=Abstract acyclovir Zovirax




J Infect Dis. 1996 Jan;173(1):1-6.
Effect of antibody alone and combined with acyclovir on neonatal herpes simplex virus infection in guinea pigs.

Bravo FJ, Bourne N, Harrison CJ, Mani C, Stanberry LR, Myers MG, Bernstein DI.

Division of Infectious Diseases, Children's Hospital Research Foundation, Cincinnati, Ohio 45229, USA.

Neonatal herpes simplex virus (HSV) infection produces severe disease with unacceptable morbidity and mortality with current antiviral therapies. The effect of therapy with passive anti-HSV antibody and acyclovir was evaluated using a guinea pig model of neonatal HSV. Newborn animals were inoculated intranasally and treated with acyclovir (60 mg/kg/day) or antibody (or both), beginning on days 0, 2, or 3 after HSV-2 inoculation. Acyclovir alone was effective only when begun on day 0, and antibody alone was effective when begun on or before day 2. Only combination therapy was effective on day 3, reducing mortality from 82% (14/17) in controls to 44% (7/16; P < .05). Combined therapy also significantly reduced the duration of skin, eye, and mouth disease and respiratory symptoms but not recurrent disease. These data suggest that addition of antibody therapy to acyclovir may improve the outcome of neonatal HSV disease.

Online pharmacy ref source - acyclovir: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8537645&dopt=Abstract acyclovir Zovirax




Antiviral Res. 1995 Aug;27(4):325-34.
The ribonucleotide reductase inhibitor (E)-2'-fluoromethylene-2'-deoxycytidine (MDL 101,731): a potential topical therapy for herpes simplex virus infection.

Bridges CG, Ahmed SP, Sunkara PS, McCarthy JR, Tyms AS.

Marion Merrell Dow Research Institute Laboratories, MRC Collaborative Centre, London, UK.

The ribonucleotide reductase inhibitor MDL 101,731 was examined for antiviral activity against herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in vitro and in combination with acyclovir in the murine zosteriform model of HSV-1 infection. The in vitro antiviral activity (IC50) for both serotypes of HSV was similar and in the range 23-98 nM for Vero cells. Comparable activities were obtained against acyclovir-resistant viruses. In the zosteriform model, topical combination therapy of MDL 101,731 with acyclovir (5%:5% w/w) applied 48 h after infection was more effective than acyclovir alone and even appeared to promote lesion resolution.

Online pharmacy ref source - acyclovir: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8540753&dopt=Abstract acyclovir Zovirax




Nephron. 1996;74(2):337-41.
Clinical pharmacokinetics of oral acyclovir in patients on continuous ambulatory peritoneal dialysis.

Stathoulopoulou F, Almond MK, Dhillon S, Raftery MJ.

Centre for Pharmacy Practice, School of Pharmacy, University of London, UK.

It is increasingly recognised that dose adjustment of oral acyclovir in continuous ambulatory peritoneal dialysis (CAPD) patients is necessary to avoid neurotoxicity. A single 800-mg oral dose of acyclovir was administered to 10 uninfected anuric patients who were treated by CAPD. Serial blood and CAPD bag samples were analysed for acyclovir during the 31 h after dosing. Serum acyclovir levels were measured using radioimmunoassay and the pharmacokinetic parameters were estimated by linear regression using the STRIPE computer programme. Peak plasma levels of 8.95 +/- 3.95 microM were achieved at 4.1 +/- 1.85 h with the T1/2 calculated to be 14.52 +/- 3 h. The mean predicted serum acyclovir levels at steady state after 1,600-, 800- and 600-mg daily doses were 13.76, 6.88 and 5.16 microM, respectively. The present recommended daily doses of acyclovir (1,600 mg) for end-stage renal disease patients leads to supratherapeutic levels therefore increasing the risk and incidence of neurotoxicity. Computer modelling of various dosage simulations suggests that daily doses of 800 and 600 mg will achieve therapeutic levels (4-8 microM).

Online pharmacy ref source - acyclovir: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8893152&dopt=Abstract acyclovir Zovirax




Eur J Ophthalmol. 1995 Oct-Dec;5(4):214-8.
A retrospective study on the effectiveness of oral acyclovir to prevent herpes simplex recurrence in corneal grafts.

van Rooij J, Rijneveld WJ, Remeijer LJ, Beekhuis WH.

Department of Cornea and External Disease, Eye Hospital Rotterdam, The Netherlands.

OBJECTIVE: A retrospective study of the effectiveness of prophylactic acyclovirn to prevent recurrent infections after penetrating keratoplasty for herpetic macula. METHODS. Follow-up data of 22 patients who where treated prophilactically with oral acyclovir (2 x 400 mg for the first three months after keratoplasy) and of 19 control patients were compared. All patients were operated between 1989-1991 after being free of recurrent Herpes simplex virus (HSV) infections for a minimal period of six months. Survival was defined as the probability of being free of HSV recurrence. RESULTS. The hazard ratio calculated for the data of a 24 month follow-up was 0.66 (95%Cl: 0.47, 3.8). Survival probabilities at six months were 0.95 for the prophylaxis and 0.74 for the control group (95%Cl of the difference: 0.07, 0.37); after 12 months these proportions were 0.72 and 0.54 respectively (95% Cl: -0.13, 0.47). CONCLUSIONS. In concordance with former studies we conclude that acyclovir may be effective as a prophylaxis in this category of patients. The probability of being free from recurrence was significantly different after six months but not after twelve, possibly indicating that the period of prophylaxis was too short.

Online pharmacy ref source - acyclovir: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8963156&dopt=Abstract acyclovir Zovirax