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An Evidence-Based Review

Christina Cernik, MD; Kelly Gallina, MD; Robert T. Brodell, MD

Arch Intern Med. 2008;168(11):1137-1144.

Genital and labial herpes simplex virus infections are frequently encountered by primary care physicians in the United States. Whereas the diagnosis of this condition is often straightforward, choosing an appropriate drug (eg, acyclovir, valacyclovir hydrochloride, or famciclovir) and dosing regimen can be confusing in view of (1) competing clinical approaches to therapy; (2) evolving dosing schedules based on new research; (3) approved regimens of the Food and Drug Administration that may not match recommendations of the Centers for Disease Control and Prevention or of other experts; and (4) dissimilar regimens for oral and genital infections. The physician must first choose an approach to treatment (ie, intermittent episodic therapy, intermittent suppressive therapy, or chronic suppressive therapy) based on defined clinical characteristics and patient preference. Then, an evidence-based dosing regimen must be selected. In this review, data from all sources are tabulated to provide a handy clinical reference.

Author Affiliations: Northeastern Ohio Universities College of Medicine, Rootstown (Drs Cernik and Brodell); First Capital Dermatology, Adena Health System, Chillicothe, Ohio (Dr Gallina); and Departments of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio, and University of Rochester School of Medicine, Rochester, New York (Dr Brodell).