From the Guidelines
For herpetic gingivostomatitis, the recommended aciclovir treatment is 200mg five times daily for 5-7 days in adults, or 15mg/kg five times daily (maximum 200mg per dose) for 5-7 days in children, as supported by the most recent and highest quality study 1. Treatment should ideally begin within 72 hours of symptom onset for maximum effectiveness. Oral aciclovir suspension is available for children and those who have difficulty swallowing tablets. Supportive care is also important, including:
- Adequate hydration
- Soft diet
- Pain management with acetaminophen or ibuprofen Topical anesthetics like lidocaine gel may help with oral pain. Aciclovir works by inhibiting viral DNA synthesis, preventing herpes simplex virus replication. Early treatment shortens the duration of symptoms, reduces viral shedding, and may prevent complications. For immunocompromised patients, higher doses or intravenous administration may be necessary, and these patients should be monitored closely 1. It's worth noting that while other studies suggest different treatment regimens, such as 400 mg orally twice a day 1 or 5-10 mg/kg body weight IV every 8 hours for 5-7 days 1, the most recent and highest quality study 1 supports the recommended treatment of 200mg five times daily for 5-7 days in adults, or 15mg/kg five times daily (maximum 200mg per dose) for 5-7 days in children.
From the Research
Recommended Aciclovir Treatment Course
The recommended Aciclovir treatment course for herpetic gingivostomatitis is as follows:
- The proposed therapeutic dose is 15 mg/kg, 5 times daily for 5 to 7 days 2, 3, 4
- Treatment should be started within the first 3 days of disease onset 2, 3, 4
Duration of Treatment
The duration of treatment with Aciclovir for herpetic gingivostomatitis is:
Efficacy of Aciclovir
Aciclovir has been shown to be effective in reducing the duration of oral lesions, fever, eating and drinking difficulties, and viral shedding in children with herpetic gingivostomatitis 2, 3, 4, 5