Recommendations for the management of herpes zoster (pdf)

Clin Infect Dis. 2007 Jan 1;44 Suppl 1:S1-S26. Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, Betts RF, Gershon AA, Haanpaa ML, McKendrick MW, Nurmikko TJ, Oaklander AL, Oxman MN, Pavan-Langston D, Petersen KL, Rowbotham MC, Schmader KE, Stacey BR, Tyring SK, van Wijck AJ, Wallace MS, Wassilew SW, Whitley RJ.


The objective of this article is to provide evidence-based recommendations for the management of patients with herpes zoster (HZ) that take into account clinical efficacy, adverse effects, impact on quality of life, and costs of treatment. Systematic literature reviews, published randomized clinical trials, existing guidelines, and the authors' clinical and research experience relevant to the management of patients with HZ were reviewed at a consensus meeting. The results of controlled trials and the clinical experience of the authors support the use of acyclovir, brivudin (where available), famciclovir, and valacyclovir as first-line antiviral therapy for the treatment of patients with HZ. Specific recommendations for the use of these medications are provided. In addition, suggestions are made for treatments that may further reduce pain and other complications of HZ when used in combination with antiviral therapy.

Reference List

Dworkin,R.H., O'Connor,A.B., Backonja,M., Farrar,J.T., Finnerup,N.B., Jensen,T.S., Kalso,E.A., Loeser,J.D., Miaskowski,C., Nurmikko,T.J., Portenoy,R.K., Rice,A.S., Stacey,B.R., Treede,R.D., Turk,D.C., and Wallace,M.S., Pharmacologic management of neuropathic pain: evidence-based recommendations, Pain, 132 (2007) 237-251.

Haanpaa,M.L., Backonja,M.M., Bennett,M.I., Bouhassira,D., Cruccu,G., Hansson,P.T., Jensen,T.S., Kauppila,T., Rice,A.S., Smith,B.H., Treede,R.D., and Baron,R., Assessment of neuropathic pain in primary care, Am J Med, 122 (2009) S13-S21.