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Ciprofloxacin 500 mg for std symptoms of cold sores after 8 weeks, but in only 5% of patients treated by this therapy (4). Also, it is very difficult to determine an objective index of the efficacy this therapy and best dose of this oral therapy is still not known, although no difference in response has been seen using this assay (20,26). Vibrational therapy in acute herpes zoster has not been extensively studied, but some promising results from clinical trials in patients with herpes zoster treated nonsteroidal antiinflammatory drugs (NSAIDs) have recently been reported (6,10,11,13). Several in vitro and vivo investigations have recently shown a decrease in viral load and the number of vesicular lesions induced by infection with herpes simplex virus 2 as well a more rapid and potent reduction in the number of clinical symptoms herpes zoster with VUV-based therapy compared placebo (13,14). Moreover, these findings were sustained at 24 weeks and beyond in randomized trials (14,10). Our group has buy fluconazole 50mg capsules been conducting a multicenter, randomized, double-blinded trial that was performed on a population of patients with acute herpes zoster. To our knowledge, this is the only randomized, controlled trial to be performed in patients infected with HSV-1 and to evaluate the efficacy of intravenous VUV therapy (2,4,12,20) on the clinical outcomes of treatment. Based on the data published in literature, most other controlled trials have been conducted on symptomatic HSV-2 carriers (12,20). The most successful controlled trial showed that both an initial treatment phase with intravenous Sildenafil prescription uk VUV and a second treatment (1). The VUV was administered at a dose of 4 mg/kg as an IV solution over 3 min after an initial dose of 6 mg/kg. In this study, a dose of 4 mg/kg resulted in a decrease viral load of approximately 10 log10 copies/mL and a significant decrease in symptoms nearly one third of patients (10). However, this study reported only a single-arm trial and had high risk of dropout; therefore, no conclusions can be drawn from the data. Another controlled trial conducted in patients with HSV-1 or HSV-2 infection showed a significant reduction in viral load and the number of clinical symptoms HSV-2 (13). This study also noted a decreased incidence (p = 0.006) of herpes zoster with the use of VUV treatment compared with placebo (4). A recent analysis of all placebo-controlled HSV-2 trials conducted in humans reported that the addition of VUV therapy did not significantly reduce viral load of the virus or significantly reduce frequency of clinical symptoms (22). Thus, there is evidence to suggest that the use of intravenous administration VUV does not reduce viral load in a substantial proportion of patients with HSV-1 and/or HSV-2 infection; nor does it reduce the frequency of symptoms related to the treatment. In the study to be completed by us, one-quarter of the treatment population and half placebo group will be treated with a dose of 4 mg/kg as an IV solution, whereas open-label trial at a different dose of 3 mg/kg will be performed in the other half. During first treatment week (1), we plan to administer 0.3 mg/kg VUV. We will then determine the optimal dose and dosing schedule that has a therapeutic benefit. We will continue VUV administration for another 8 weeks to determine whether the use of this combination increases or decreases the frequency of clinical symptoms and improves the response to treatment. Although there are several limitations to our study, including the nature of patient population as it relates to HSV-1 and HSV-2 infection (27,28,29), the study duration, it seems clear to some degree that the use of IV treatment patients with HSV-1 and/or HSV-2 infection could potentially provide patients with symptoms of herpes zoster an immediate objective effect on the clinical outcome. However, outcome of intravenous VUV may not be as readily evident in this study because of the higher dose and duration of this therapy than in the existing randomized controlled trials. Also, the duration of study will vary slightly based on initial response, treatment duration and Fluconazole 90 Pills $471 - $429 Per pill adverse events (which can result in a decrease the rate of symptom improvement). Therefore, it becomes very difficult to predict an objective and clinically relevant outcome as a result of the VUV therapy. However, these data should assist physicians in selecting the optimal dosage to achieve a therapeutic effect and in assessing adverse events. Furthermore, there are clinical benefits from these agents. For example, the use of this therapy increases the likelihood of symptom relief through immediate treatment; however, there has also been a decrease in the incidence of adverse events (29). As this has been demonstrated an objective and clinically relevant benefit of VUV therapy, it seems clear.
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