trimethoprim--sulfamethoxazole-drug-combination and Herpes-Genitalis

Forty patients presenting with first episode genital herpes were randomly allocated to seven day treatment with oral acyclovir alone, placebo alone, oral acyclovir plus co-trimoxazole, or placebo plus co-trimoxazole. Patients receiving acyclovir had significantly shorter periods of viral shedding (p less than 0.001), pain (p = 0.03), and times to lesion healing (p less than 0.05). Averaged over all patients there was no evidence that co-trimoxazole affected any of the variables, though in women cotrimoxazole was associated with a shorter time to lesion healing (p less than 0.01). Furthermore, the combination treatment gave significantly shorter times to lesion healing than acyclovir alone, placebo alone, or placebo and co-trimoxazole (p = 0.01) and good trends elsewhere (external lesions and duration of pain). Neither drug was associated with any adverse events or toxicity or influenced the subsequent recurrence rate.

Topics: Acyclovir; Adolescent; Adult; Clinical Trials as Topic; Drug Combinations; Drug Therapy, Combination; Female; Herpes Genitalis; Humans; Male; Random Allocation; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Auto-inoculation from a genital ulcer suspected of being ulcus molle gave redness after 24 hours and after 48 hours vesicles and pustules appeared. Cultivation from the auto-inoculation after the 48 hours was positive for herpes simplex virus type 2. Our observation underlines two points: auto-inoculation for the diagnosing of Haemophilus ducreyi infection may be mimicked by herpes simplex infection, and the incubation period of herpes simplex can be shorter than the 4-5 days usually given.

Topics: Adult; Autoantibodies; Chancroid; Diagnosis, Differential; Drug Combinations; Female; Haemophilus ducreyi; Herpes Genitalis; Humans; Male; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination