Acyclovir in pediatric Herpes Simplex Virus (HSV) keratitis

Purpose. Acyclovir has been used in the treatment of HSV keratitis in adult patients with recurrent infectious disease, and prophylactically in immunosuppressed individuals and after penetrating keratoplasty. The purpose of this study is to evaluate the use of acyclovir in a group of pediatric patients with HSV keratitis. Methods. Four patients ranging in age from 7 weeks to 3 years were treated with oral acyclovir in addition to topical antivirals and/or anti-inflammatories for HSV keratitis. Three of four of the patients failed previous therapy with topical antiviral medications alone. The fourth patient was treated primarily with Acyclovir. Maintenance therapy with Acyclovir was used in three of the four patients (mean duration = 9 months) to prevent recurrent disease. Results. All patients showed resolution of the disease with minimal corneal scarring. All patients tolerated the medication well and there were no adverse drug reactions in any of the patients. Conclusions. Oral acyclovir is a useful adjunct to topical therapy in pediatric patients with HSV keratitis.