51. Impact of Adherence (Compliance) to Oral Acyclovir Prophylaxis in the Recurrence of Herpetic Keratitis: Long-Term Results From a Pediatric Cohort.
- Author
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Luccarelli SV, Lucentini S, Martellucci CA, Marelli L, Sacchi M, and Nucci P
- Subjects
- Administration, Oral, Antibiotic Prophylaxis, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Keratitis, Herpetic epidemiology, Keratitis, Herpetic physiopathology, Male, Reinfection epidemiology, Reinfection physiopathology, Retrospective Studies, Treatment Outcome, Visual Acuity physiology, Acyclovir administration & dosage, Antiviral Agents administration & dosage, Keratitis, Herpetic prevention & control, Reinfection prevention & control, Assessment of Medication Adherence
- Abstract
Purpose: To evaluate the long-term role of adherence to oral acyclovir prophylaxis in reducing the risk for recurrent herpes simplex virus keratitis (HSK) in children., Methods: A retrospective cohort study was performed including all pediatric patients 16 years or younger) with their first HSK diagnosis and treatment at our center. Children were started on a standardized oral acyclovir prophylactic regimen after the acute phase. Adherence to prophylaxis was assessed monthly through parent interviews. The possible association between any recurrence (not only the first) and exposure to acyclovir prophylaxis was evaluated using random-effects multivariate logistic regression., Results: A total of 20 eyes of 17 patients (8 boys and 9 girls) were included. The mean follow-up time was 3.5 years. Adherence to acyclovir prophylaxis was registered in 100% of patients with no recurrences and in 36.4% of patients with 1 or more recurrences (P = 0.035). All other tested variables (time of follow-up, sex, age, infectious diseases, underlying hematological diseases, eye, and HSK type) did not differ between the 2 groups. The multivariate model confirmed the lower risk for recurrence in patients who were compliant to therapy (adjusted odds ratio 0.04, 95% confidence intervals 0.00-0.42, P = 0.008). No adverse effects were recorded during follow-up., Conclusions: Oral acyclovir prophylaxis is a safe and an effective medical treatment for recurrent HSK and its long-term efficacy is associated with compliance to the therapy., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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