The use of oral acyclovir in otherwise healthy children with varicella

Oral acyclovir therapy initiated within 24 hours of illness for otherwise healthy children with varicella typically will result in a 1-day reduction of fever and approximately a 15% to 30% reduction in the severity of cutaneous and systemic signs and symptoms. Therapy has not been shown to reduce the rate of acute complications, pruritus, spread of infection, or duration of absence from school. Its long-term effect on the rate of occurrence of zoster is unknown. To date, no significant adverse effects of oral acyclovir therapy in otherwise healthy children have been demonstrated. In adults, delay of therapy beyond the first 24 hours of illness results in loss of therapeutic effect. The cost-benefit ratio of therapy is currently unknown, and its determination is extremely complex.