Chickenpox medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

There is no definitive treatment for chicken pox, supportive treatment to minimize discomfort and pruritus.

Medical Therapy

Symptomatic treatment

  • Mild sodium bicarbonate baths, antihistamine medication to help ease itching
  • Acetaminophen to reduce fever.
  • Ibuprofen
  • ASPIRIN MUST NOT BE GIVEN to children with chickenpox to avoid potentially fatal Reye's Syndrome. [1][2]
  • Topical application of calamine lotion [3] Calamine lotion is no longer recommended due to its excessive drying nature.
  • Maintaining adequate hydration
  • Intravenous Immunoglobulin therapy is also considered in pregnant women, immunocompromised patients and newborns who are not vaccinated.

Anti-viral Therapy

  • Anti-viral therapy for chickenpox has been observed to be beneficial if given within the first 24hrs of the appeaerance of the rash.[4][5]
  • 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. [6]
  • Valacyclovir is given as 20 mg per kg per dose every 8th hourly for 5 days. (Dose not to exceed 1000 mg per day.
Contraindicated Medications

References

  1. US Centers for Disease Control and Prevention. "Varicella Treatment Questions & Answers". CDC Guidelines. CDC. Retrieved 2007-8-23. Check date values in: |accessdate= (help)
  2. 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.
  3. 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)
  4. "A Controlled Trial of Acyclovir for Chickenpox in Normal Children — NEJM".
  5. 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.
  6. 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.


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