From the Research
Oral acyclovir is not recommended for the treatment of hand, foot, and mouth disease (HFMD) in children. HFMD is a viral infection typically caused by enteroviruses, most commonly coxsackievirus A16 and enterovirus 71, not by herpes viruses that acyclovir targets 1, 2. Treatment for HFMD is primarily supportive care, focusing on symptom management. This includes:
- Ensuring adequate fluid intake to prevent dehydration, especially if mouth sores make drinking painful
- Using acetaminophen or ibuprofen for fever and pain relief (dosing based on child's weight per package instructions)
- Offering cold, soft foods that don't irritate mouth sores
- Using topical oral anesthetics like benzocaine to temporarily relieve mouth pain The illness is generally self-limiting and resolves within 7-10 days without specific antiviral treatment 2, 3. Parents should seek medical attention if their child shows signs of dehydration, persistent high fever, unusual drowsiness, or if symptoms worsen or don't improve after a few days. Handwashing and avoiding close contact with infected individuals are important preventive measures 1, 2. Although some studies suggest the potential use of oseltamivir as an adjunctive therapy for HFMD 4, the current evidence does not support the use of oral acyclovir for this condition. An older study suggested a potential benefit of acyclovir in HFMD 5, but this finding is not supported by more recent and higher-quality evidence.