Chickenpox medical therapy
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Chickenpox usually doesn't require any medical therapy in otherwise healthy individuals. Only symptomatic treatment is usually prescribed to ease the discomfort. The complexity of the therapy grows when many risk factors are involved.
Medical Therapy
Pharmacotherapy
- Chickenpox infection tends to be milder the younger a child is.
- Symptomatic treatment with mild sodium bicarbonate baths, antihistamine medication to help ease itching[1] and paracetamol (acetaminophen) to reduce fever are widely used. Ibuprofen can also be used on advice of a doctor. However, aspirin or products containing ASPIRIN MUST NOT BE GIVEN to children with chickenpox (or any fever-causing illness), as this risks causing the serious and potentially fatal Reye's Syndrome. [2]
- There is no evidence to support the effectiveness of topical application of calamine lotion which is a topical barrier preparation containing zinc oxide in spite of its wide usage and excellent safety profile.[3] Calamine lotion is no longer recommended due to its excessive drying nature.
- Non-medical interventions such as lukewarm baths with a skin-soothing oatmeal or cornstarch are also followed traditionally.
- Maintaining adequate hydration also helps the body get rid of the viral load.
- Anti-viral therapy is also considered taking the co-morbid conditions into factor.
- Intravenous Immunoglobulin therapy is also considered if an individual has been exposed to someone with the infection but doesn't have any symptoms yet. Its occasionally given to pregnant women, immunocompromised patients and newborns who have been exposed to the chickenpox virus.
Anti-viral Therapy
- Anti-viral therapy for chcickenpox has been observed to be beneficial if given within the first 24hrs of the appeaerance of the rash.
- It is important to check the renal function before proceeding with administration of anti-viral therapy for chickenpox.
- Acyclovir and valacyclovir are considered for individuals who are two years and above. Acyclovir is preferred over valcyclovir because of its better safety profile.
- The antiviral therapy varies
- Acyclovir is given as 20 mg per kg per dose every 6th hourly for age groups of 2 to 12 years and for adolescents. Dose not to exceed 800 mg per day.
- Valacyclovir is given as 20 mg per kg per dose every 8th hourly for 5 days. (Dose not to exceed 1000 mg per day. [6]
Contraindicated Medications
References
- ↑ Somekh E, Dalal I, Shohat T, Ginsberg GM, Romano O (2002). "The burden of uncomplicated cases of chickenpox in Israel". J. Infect. 45 (1): 54–7. PMID 12217733.
- ↑ US Centers for Disease Control and Prevention. "Varicella Treatment Questions & Answers". CDC Guidelines. CDC. Retrieved 2007-8-23. Check date values in:
|accessdate=(help) - ↑ Tebruegge M, Kuruvilla M, Margarson I (2006). "Does the use of calamine or antihistamine provide symptomatic relief from pruritus in children with varicella zoster infection?". Arch. Dis. Child. 91 (12): 1035–6. doi:10.1136/adc.2006.105114. PMID 17119083. Text "format-Abstract" ignored (help)
- ↑ "A Controlled Trial of Acyclovir for Chickenpox in Normal Children — NEJM".
- ↑ Wallace MR, Bowler WA, Murray NB, Brodine SK, Oldfield EC (1992). "Treatment of adult varicella with oral acyclovir. A randomized, placebo-controlled trial". Ann. Intern. Med. 117 (5): 358–63. PMID 1323943.
- ↑ Kechagia IA, Kalantzi L, Dokoumetzidis A (2015). "Extrapolation of Valacyclovir Posology to Children Based on Pharmacokinetic Modeling". Pediatr. Infect. Dis. J. 34 (12): 1342–8. doi:10.1097/INF.0000000000000910. PMID 26379165.