Factors indicative of outcome in a comparative trial of acyclovir and vidarabine for biopsy-proven herpes simplex encephalitis.

Abstract:

:A total of 208 patients underwent brain biopsy for presumptive herpes simplex encephalitis and were randomized to receive either vidarabine, vira-A, at 15 mg/kg/day, or acyclovir, at 30 mg/kg/day for ten days. 69 patients (33%) had biopsy-proven disease; 37 received vira-A and 32 acyclovir. With the exception of age, patient populations were balanced for demographic characteristics. Overall survival for acyclovir recipients was 72% compared with 46% for vira-A-treated patients 18 months after therapy (p = 0.008). After adjustment for differences of age between treatment populations by multivariant regression analyses, acyclovir treatment remained superior to vidarabine therapy (p = 0.041). Mortality varied according to the level of consciousness at the onset of therapy. For lethargic, semicomatose and comatose patients, mortality was 42%, 46%, and 67%, respectively, for the vira-A-treated patients and 0%, 25% and 25%, respectively, for acyclovir-treated patients. Six months post-therapy morbidity assessments revealed five (14%) vira-A versus 12 (38%) acyclovir recipients who had returned to normal function, while eight (22%) and three (9%), respectively, had moderate debility. Outcome differences were significant (p = 0.02; Wilcoxon, 2-sample test) using an adapted scoring system. Age and Glasgow coma scale greater than 10 predicted the best outcome following acyclovir treatment. Disoriented patients who flex and respond by eye to pain had no mortality and 50% returned to normal. These data indicate that acyclovir is the treatment of choice for biopsy-proven herpes simplex encephalitis.

journal_name

Infection

journal_title

Infection

authors

Whitley RJ,Alford CA,Hirsch MS,Schooley RT,Luby JP,Aoki FY,Hanley D,Nahmias AJ,Soong SJ

doi

10.1007/BF01650104

subject

Has Abstract

pub_date

1987-01-01 00:00:00

pages

S3-8

eissn

0300-8126

issn

1439-0973

journal_volume

15 Suppl 1

pub_type

临床试验,杂志文章,随机对照试验
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    journal_title:Infection

    pub_type: 杂志文章

    doi:10.1007/BF01644102

    authors: Hohl P,von Graevenitz A,Zollinger-Iten J

    更新日期:1988-05-01 00:00:00

  • The effects of pretransplant conditioning, graft-versus-host disease and sepsis on the CRP levels in bone marrow transplantation.

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    pub_type: 杂志文章

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    更新日期:1997-11-01 00:00:00

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    pub_type: 杂志文章,评审

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    更新日期:1992-01-01 00:00:00

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    pub_type: 杂志文章,评审

    doi:10.1007/BF02561663

    authors: Hryniewicz W

    更新日期:1999-01-01 00:00:00

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    doi:10.1007/BF01643385

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    pub_type: 临床试验,杂志文章

    doi:10.1007/BF01640667

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    更新日期:1982-01-01 00:00:00

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    pub_type: 临床试验,杂志文章,随机对照试验

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    authors: Heidl M,Scholz H,Dörffel W,Hermann J

    更新日期:1991-11-01 00:00:00

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    doi:10.1007/s150100050036

    authors: Nastasi A,Mammina C

    更新日期:1999-11-01 00:00:00

  • Safety and immunogenicity of an inactivated hepatitis A vaccine in children 2 to 5 years old.

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    pub_type: 临床试验,杂志文章

    doi:10.1007/BF01716302

    authors: Arístegui J,Morales JL,Dal-Ré R,González A,Gallego MS,Garrote E

    更新日期:1995-09-01 00:00:00

  • Turicella otitidis and Corynebacterium auris: 20 years on.

    abstract::Turicella otitidis and Corynebacterium auris, described as new species 20 years ago, have been isolated mainly from the external ear canal and middle ear fluid. While their taxonomic position has been clearly established, their diagnosis in the routine laboratory is difficult. The question of their pathogenic potentia...

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    pub_type: 杂志文章,评审

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  • Comparative in vitro activity of cefpodoxime against anaerobes other than Bacteroides fragilis.

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    pub_type: 杂志文章

    doi:10.1007/s15010-001-1028-7

    authors: Naqvi B,Dorsky D,Ali SA,Feingold JM,Edwards RL,Bona RD,Clive J,Tutschka PJ,Bilgrami S

    更新日期:2001-08-01 00:00:00

  • A prognostic score for postherpetic neuralgia in ambulatory patients.

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    pub_type: 杂志文章

    doi:10.1007/BF02770836

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    更新日期:1998-11-01 00:00:00

  • Infection in immunodepressed patients. The approach to diagnosis and treatment.

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    pub_type: 杂志文章

    doi:10.1007/BF01642766

    authors: Nauta EH,van Furth R

    更新日期:1975-01-01 00:00:00

  • Colistin and trimethoprim-sulfamethoxazole for the prevention of infection in patients with acute non-lymphocytic leukaemia. Decrease in the emergence of resistant bacteria.

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    pub_type: 杂志文章

    doi:10.1007/BF01641298

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    更新日期:1983-05-01 00:00:00

  • Group B streptococcal disease in infants in the first year of life: a nationwide surveillance study in Japan, 2011-2015.

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    pub_type: 杂志文章

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