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Review: early treatment of acute herpes zoster may prevent or shorten the duration of postherpetic neuralgia

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 QUESTION: In patients with acute herpes zoster, do any treatments alter the incidence or duration of postherpetic neuralgia (PHN)?

Data sources

Studies were identified by searching Medline (1966 to 28 December 1998) and the Cochrane Controlled Trials Register 1998, by reviewing the reference lists of identified articles, and by doing web based searches.

Study selection

English language studies were selected if they were randomised controlled trials (RCTs) that enrolled patients with acute herpes zoster and that reported on relevant outcome measures (incidence of pain at any time after rash healing or duration of zoster associated pain or PHN).

Data extraction

Data were extracted independently by 2 reviewers on study methods, patient characteristics, intervention type and duration, length of follow up, number of dropouts, and outcome measures.

Main results

42 studies met the selection criteria. The results from 4 RCTs (n=692) and 4 meta-analyses done using these 4 trials indicated that oral acyclovir, 800 mg 5 …

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  • Source of funding:no external funding.

  • For correspondence: Dr B S Alper, University of Missouri–Columbia, MA 303E Health Sciences Building DC032-00, Columbia, MO 65212, USA. AlperB{at}