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• W2808708558 abstract "To the Editor: The debate regarding whether acyclovir should be switched to over-the-counter (OTC) status has persisted for decades, and there continues to be an increase in physician visits for herpes simplex virus (HSV)-1 and HSV-2. Genital and oral herpes are widespread and can facilitate the spread of human immunodeficiency virus (HIV). Twenty-three years ago, in May 1994, a Food and Drug Administration public hearing and Antiviral/Nonprescription Drugs Advisory Committees Joint meeting convened to discuss the switch of oral acyclovir from prescription to OTC for the suppression and treatment of genital herpes. Many issues were considered, such as transmission, virology, and treatment. In 1996, to reconsider the findings from this meeting, Sande et al1 held an independent ad hoc meeting to address these issues regarding the use of oral acyclovir as a 5-day episodic treatment for genital herpes. After examining the same issues as the 1994 meeting but excluding the issue of chronic suppressive versus episodic therapy, Sande et al1 determined that such concerns as self-diagnosis, safety, misdiagnosis, and misuse were not the most critical issues at the time. The panel decided not to approve the switch of oral acyclovir to an OTC antiviral medication primarily because it would establish a precedent for OTC antibiotic medications and could expedite the development of microbial and viral resistance.1 Since both the meeting and the panel, many large studies have shown no significant increase in resistance of herpes to acyclovir or valacyclovir in immunocompetent patients despite widespread use of these medications.2–4 Herpes simplex virus resistance rates to acyclovir are less than 1% in immunocompetent patients (Table 1).2–4 Toxicity of acyclovir and valacyclovir is significantly less than that of other OTC medications, including ibuprofen and acetaminophen. Over-the-counter availability would increase access and empower patients.5 Because HSV requires prompt treatment to decrease the duration and severity of symptoms, the ability to more readily self-treat using OTC acyclovir or valacyclovir would also reduce physician visits due to HSV episodes and possibly reduce transmission because of quicker resolution of symptoms.5 It is time to readdress the availability of OTC treatment for HSV.TABLE 1: HSV Resistance to Acyclovir and/or Valacyclovir in Immunocompetent PatientsAlyssa M. Aldridge, BA The Warren Alpert Medical School of Brown University Providence, Rhode IslandFrancine Touzard Romo, MDTimothy P. Flanigan, MD The Warren Alpert Medical School of Brown University Division of Infectious Diseases The Miriam Hospital Providence, Rhode Island [email protected]" @default.
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• W2808708558 date "2018-11-01" @default.
• W2808708558 modified "2023-09-26" @default.
• W2808708558 title "Time to Switch Herpes Simplex Virus Oral Medications From Prescription to Over-the-Counter" @default.
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• W2808708558 doi "https://doi.org/10.1097/ipc.0000000000000662" @default.
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