penciclovir and docosanol

During the last three decades, a better understanding of viral replication and disease states caused by viral infections have led to the development of newer antiviral agents with enhanced activity and better tolerability. This review focuses on newer systemic and topical antiviral agents that are used in treatment of herpes viruses including herpes simplex type-1 (HSV-1) and type-2 (HSV-2), varicella-zoster virus (VZV) and cytomegalovirus CMV) as well as the human papilloma virus (HPV). Included in this article are the agents famciclovir, penciclovir, valganciclovir, imiquimod, docosanole and brivudin.

Topics: 2-Aminopurine; Acyclovir; Aminoquinolines; Antiviral Agents; Bromodeoxyuridine; Famciclovir; Fatty Alcohols; Ganciclovir; Guanine; Humans; Imiquimod; Valganciclovir; Virus Diseases

Topics: Acyclovir; Antiviral Agents; Clinical Trials as Topic; Fatty Alcohols; Guanine; Herpes Labialis; Humans; Ointments

Topics: Acyclovir; Antiviral Agents; Fatty Alcohols; Guanine; Herpes Labialis; Humans; Recurrence; Simplexvirus; Stomatitis, Herpetic; Virulence; Virus Activation; Virus Shedding

There are 3 new topical treatments for herpes labialis that have either been approved by the US Food and Drug Administration (penciclovir cream [Denavir] and n-docosanol cream [Abreva]) or recently undergone extensive clinical evaluation (acyclovir cream). The relative efficacy of these products is unknown.. To compare the efficacy of penciclovir cream, acyclovir cream, n-docosanol cream, and acyclovir ointment in an experimental animal model of cutaneous herpes simplex virus type 1 (HSV-1) disease.. The backs of guinea pigs were infected with HSV-1 using a vaccination instrument. Active treatments and corresponding vehicle controls were applied for 3 to 5 days beginning 24 hours after inoculation.. After completion of treatment, the animals were killed and the severity of the infection assessed from the number of lesions, the total lesion area, and the lesion virus titer.. Penciclovir cream effected modest reductions in lesion number (19%), area (38%), and virus titer (88%) compared with its vehicle control, and each of these differences was significantly greater (P<.05) than the reductions effected by acyclovir ointment (0%, 21%, and 75%, respectively). The acyclovir cream effect (reductions of 4%, 28%, and 77%, respectively) was less than that of penciclovir cream, and this difference was confirmed by 2 additional head-to-head experiments. Two experiments with n-docosanol cream failed to show statistically significant differences by any parameter between n-docasonol cream and vehicle control-treated sites or between n-docosanol and untreated infection sites.. In this model, the efficacy of penciclovir cream was greater than acyclovir cream, acyclovir cream was greater than or equal to acyclovir ointment, and acyclovir ointment was greater than n-docosanol cream. Since our model was designed to evaluate compounds that function primarily through antiviral activity, the negative findings with n-docosanol in these studies do not exclude that it might work clinically through other mechanisms.

Topics: Acyclovir; Administration, Topical; Animals; Disease Models, Animal; Fatty Alcohols; Female; Guanine; Guinea Pigs; Herpes Labialis; Herpesvirus 1, Human; Humans; Treatment Outcome

Topics: Acyclovir; Administration, Topical; Animals; Antiviral Agents; Disease Models, Animal; Fatty Alcohols; Guanine; Guinea Pigs; Herpes Labialis; Humans; Ointments; Treatment Outcome