EFFICACY OF SHORT COURSE ORAL CORTICOSTEROIDS WITH ORAL ACYCLOVIR VERSUS ORAL ACYCLOVIR ALONE IN THE TREATMENT OF HERPES ZOSTER TO PREVENT POST HERPETIC NEURALGIA

Abstract

Objective: To investigate the Efficacy of short course oral corticosteroids with oral acyclovir versus oral acyclovir alone in the treatment of herpes zoster to prevent post herpetic neuralgia. 

Study design: It was a quasi-experimental study.

Place and duration: It was conducted at Pak Emirates military hospital Rawalpindi, from 1^st April 2024 to 1^st October 2024.

Methods: Forty-six patients diagnosed with acute HZ were divided into two equal groups: Group A receiving oral antivirals with oral corticosteroids and Group B receiving oral antivirals alone for a duration of 9 days each. Pain was assessed at multiple time points in follow up period using the Visual Analogue Scale (VAS) for up to 90 days. IBM SPSSv26 was used to run statistical testsincluding Wilcoxon signed-rank and Mann-Whitney U.

Results: All 46 patients followed up (23 in each group). The number of patients presenting with herpes zoster infection within 7 days was 19 (50%) in the non-corticosteroid group and 19 (50%) in the corticosteroid group; males were 20 (48.8%) and 21 (51.2%), respectively. There was a significant reduction in pain in both groups from Day 0 to Day 90 (p < 0.001), with 34(73.9%), 41(89.1%), and 45(97.8%) patients’ pain-free on Days 7, 30, and 90, respectively. There was no statistically significant difference in VAS pain scores between the corticosteroid and non-corticosteroid groups at baseline (p = 0.736) or at Day 90 (p = 0.317).

Conclusion: The combination therapy does not significantly impact long-term outcomes.