Intervention Review

Acyclovir for treating primary herpetic gingivostomatitis

  1. Mona Nasser1,*,
  2. Zbys Fedorowicz2,
  3. Mohammad H Khoshnevisan3,
  4. Maryam Shahiri Tabarestani4

Editorial Group: Cochrane Oral Health Group

Published Online: 8 OCT 2008

Assessed as up-to-date: 25 JUN 2008

DOI: 10.1002/14651858.CD006700.pub2

How to Cite

Nasser M, Fedorowicz Z, Khoshnevisan MH, Shahiri Tabarestani M. Acyclovir for treating primary herpetic gingivostomatitis. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD006700. DOI: 10.1002/14651858.CD006700.pub2.

Author Information

  1. 1

    Institute for Quality and Efficiency in Health care, Department of Health Information, Köln, Germany

  2. 2

    Ministry of Health, Bahrain, UKCC (Bahrain Branch), Awali, Bahrain

  3. 3

    School of Dentistry of SBMU, Community Oral Health, Tehran, Iran, Islamic Republic of

  4. 4

    App 2, 1st Floor, Babol, Iran, Islamic Republic of

*Mona Nasser, Department of Health Information, Institute for Quality and Efficiency in Health care, Dillenburger Street, 27, D-51105, Köln, D-51105, Germany. Monalisa1n@gmail.com. monanasser1@googlemail.com.

Publication History

  1. Publication Status: New
  2. Published Online: 8 OCT 2008

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Primary herpetic gingivostomatitis is a highly contagious infection of the oral cavity which typically affects children but can also occur in adults. Symptoms may vary widely from mild discomfort to life-threatening encephalitis.

Objectives

The objective of this review was to evaluate the effectiveness of systemic acyclovir for primary herpetic gingivostomatitis.

Search methods

We searched the following databases: Cochrane Oral Health Group's Trials Register (to 22 May 2008); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 2); MEDLINE (1950 to 22 May 2008); and EMBASE (1980 to 22 May 2008). There were no language restrictions.

Selection criteria

Randomised controlled trials comparing acyclovir to placebo in children and young adults < 25 years of age with a diagnosis of primary herpetic gingivostomatitis with or without herpes labialis were considered.

Data collection and analysis

Two review authors independently and in duplicate screened and extracted information from, and assessed the risk of bias in the included clinical trials. The Cochrane Collaboration statistical guidelines were followed for data synthesis.

Main results

Only two clinical trials, one with 72 participants and the other with 20 participants were included in this review. The second study failed to report several methodological items and was inconsistent in its reporting of the outcomes measurement.
The first trial, with a moderate risk of bias, showed better results in the acyclovir group compared to the placebo group in children < 6 years of age in reducing the number of individuals with oral lesions (risk ratio (RR) 0.10 (95% confidence interval (CI) 0.02 to 0.38)), new extraoral lesions (RR 0.04 (95% CI 0.00 to 0.65)), difficulty in eating (RR 0.14 (95% CI 0.03 to 0.58)), and drinking difficulties (RR 0.11 (95% CI 0.01 to 0.83)) after 8 days of treatment.
Following the onset of treatment, three patients from the placebo group were admitted to hospital for rehydration (P = 0.11).
Four children (two from the acyclovir, and two from the placebo group) showed mild gastrointestinal symptoms that resolved spontaneously after 24 to 48 hours without a change in the study treatment.

Authors' conclusions

We found two relevant trials in this systematic review, only one of them could provide some weak evidence that acyclovir is an effective treatment in reducing the number of oral lesions, preventing the development of new extraoral lesions, decreasing the number of individuals with difficulties experienced in eating and drinking and reducing hospital admission for children under 6 years of age with primary herpetic gingivostomatitis.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Acyclovir for treating primary herpetic gingivostomatitis

There is some weak evidence that acyclovir can be an effective treatment in decreasing some of the symptoms caused by primary herpetic gingivostomatitis.
Primary herpetic gingivostomatitis is a highly contagious infection of the oral cavity which is caused by the herpes simplex virus. It is prevalent in children and young adolescents and sometimes can cause uncomfortable symptoms including eating and drinking difficulties and even life-threatening inflammation of the brain (encephalitis).
This review included two trials (92 participants) but only one of them provided some limited evidence to suggest that acyclovir is an effective treatment in reducing the number of oral lesions, preventing the development of new extraoral lesions, decreasing the number of individuals with difficulties experienced in eating and drinking and of those who are admitted to hospital for children under 6 years of age with primary herpetic gingivostomatitis.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

Acyclovir用於治療原發性皰疹性齦口炎

原發性皰疹性齦口炎是一種高度傳染性的口腔感染,這通常會影響孩子,但也可能發生在成年人。症狀可能相差很大,從輕微不適到威脅生命的腦炎。

目標

這篇的回顧的目的是評估全身性acyclovir對於皰疹性齦口炎的成效。

搜尋策略

我們檢索了以下數據庫:Cochrane Oral Health Group's Trials Register (to 22 May 2008); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 2); MEDLINE (1950 to 22 May 2008); and EMBASE (1980 to 22 May 2008). 沒有語言限制。

選擇標準

隨機對照試驗,比較了acyclovir和安慰劑用於被診斷有原發性皰疹性齦口炎合併有或無唇皰疹的兒童和小於25歲的年輕人。

資料收集與分析

兩個作者獨立並且重複的篩選和提取信息,並評估了在這些臨床試驗裡所包含的偏見。用Cochrane Collaboration統計準則接著做數據的綜合。

主要結論

只有兩個臨床試驗,其中一個有72個參加者,另一個有20個參加者包括在這項回顧。第二項研究在報告裡沒有方法的項目 並在其結果測量的報告是不一致的。 在第一個試驗中,有一個中等風險的偏見,acyclovir組比對照組表現出較好的結果。在6歲以下的兒童在經過8天acyclovir的治療後,有較少口腔病變(RR:0.10,95%CI:0.02 – 0.38),新的口外病變(RR:0.04,95%CI:0.00 – 0.65),進食困難度(RR:0.14,95%CI:0.03 – 0.58),和飲水困難度(RR: 0.11,95%CI:0.01 – 0.83)。在發病後的治療,有3例對照組因為脫水而入院(P = 0.11)。有4名兒童(2個來自acyclovir組,兩名來自對照組)表現有輕度的胃腸道症狀,在24 – 48小時內自動緩解,對於研究治療沒有改變。

作者結論

我們發現在這兩個相關試驗的系統回顧中,只有其中一個試驗能夠提供薄弱的證據表明acyclovir是一種有效的治療方法,可以減少口腔病變的數量,防止發展新的口外病變,減少進食和飲水困難的人數,減少6歲以下兒童因為原發性皰疹性齦口炎而住院。

翻譯人

本摘要由臺灣大學附設醫院黃瀞慧翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

一些薄弱的證據可以證明acyclovir能有效的減少原發性皰疹性齦口炎所造成的的一些症狀。原發性皰疹性齦口炎是一種由單純皰疹病毒引起的高度傳染性的口腔感染。這在青少年和兒童之間流行,有時會導致不舒服的症狀包括進食和飲水困難,甚至是危及生命的腦炎。這個回顧包括兩個試驗(92人),但只有其中一個提供了一些有限的證據表示,acyclovir是一種有效的治療,對於減少口腔病變的數量,防止發展新的口外病變,減少進食和飲水困難,減少6歲以下兒童因為原發性皰疹性齦口炎而住院的人數。