NEW YORK (Reuters Health) - Patient-initiated, single-day famciclovir is an effective and well-tolerated treatment for recurrent genital herpes, a new study shows.

"For this to work the medication had to be started within six hours of the development of a recurrence," Dr. Fred Y. Aoki of the University of Manitoba in Winnipeg, the study's lead author, told Reuters Health. "That will require in effect an education and empowerment of the patient."

The current approved regimen for the drug is 125 mg twice daily for five days. Other approved regiments include valacyclovir twice daily for three days, and acyclovir five times a day for one day.

Dr. Aoki and his team tested the safety and efficacy of 1000 mg of famciclovir given twice daily for one day compared to placebo in 320 patients, who were told to begin taking the drug within six hours of the appearance of prodromal symptoms.

Among patients who took the drug, nonaborted lesions - those that went beyond the papule stage - lasted a median of 4.3 days compared to 6.1 days for those on placebo. Both aborted and nonaborted lesions lasted 3.5 days among patients given famciclovir compared to 5.0 days for those on placebo, and 23.3% of the patients taking the drug had aborted lesions, compared to 12.7% of those on placebo.

Patient-initiated treatment is not a new concept in the management of genital herpes, Dr. Aoki pointed out, while patients with the condition are typically very willing to take an active part in managing it. "My patients with genital herpes generally find it not too difficult to be major partners in the drug management of their disease," he said.

"This convenient single-day regimen has the potential for improving patient compliance and satisfaction with therapy," he and his colleagues conclude.

Clin Infect Dis 2006;42:6-13

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