13. Comparative study of the efficacy of valacyclovir and acyclovir in herpes zoster

In the present research work, the efficacy and safety of valacyclovir in comparison with acyclovir in the treatment of acute herpes zoster was investigated. Relevant data were taken from 60 patients with herpes zoster who presented within 72 h of the onset of rash and were randomized into two groups of 30 each. The first group received valacyclovir 1000 mg three times a day for 7 days while those in the second group received acyclovir 800 mg five times a day for 7 days respectively. Patients were followed up on day 3,8,15 and 29 to assess the rate of resolution of pain, cessation of abnormal sensations, rate of rash healing, new lesion formation and occurrence of complications. When pain scores between the groups were compared, a significant decrease was observed with valacyclovir at day 22 (P = 0.016) and 29 (P < 0.001). Valacyclovir also significantly accelerated the resolution of zoster associated pain compared with acyclovir at day 29 (P = 0.001). The rate of cessation of abnormal sensations, rash healing, new lesion formation and complications was similar with both the treatments. There were no clinically significant differences in the nature, frequency or severity of adverse events between the two treatment groups. In the management of herpes zoster, valacyclovir accelerates the resolution of pain and offers a simpler dosing regimen and maintains the favorable safety profile of acyclovir.