Efficacy of oral treatment with acyclovir and co-trimoxazole in first episode genital herpes

Abstract

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 < 0.001), pain (p = 0.03), and times to lesion healing (p < 0.05). Averaged over all patients there was no evidence that co-trimoxazole affected any of the variables, though in women co-trimoxazole was associated with a shorter time to lesion healing (p < 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.