Effect of Oral Acyclovir on Hospitalized Children with Infectious Mononucleosis: A Double-blind Clinical Trial

Background and objectives: Infectious mononucleosis is a disease mainly caused by EpsteinBarr virus. The disease is most frequently observed in children. Acyclovir is a nucleoside analogue with high in-vitro antiviral activity. The present study was performed to evaluate the therapeutic effect of oral acyclovir on hospitalized children with infectious mononucleosis. Methods: This randomized double-blind clinical trial was performed on 48 patients with infectious mononucleosis who were randomly divided into an intervention (n=22) and a control (n=26) group. The intervention group received 80 mg/kg/day oral acyclovir q.i.d. for five days and the control group received placebo (Starch capsule, Barij Essence). Clinical symptoms, test results, drug side effects and demographic information of the patients were recorded in a checklist. Data were analyzed using SPSS 18. Descriptive statistics including mean and standard deviation were used to describe data. The chi-square and Mann-Whitney tests were used for comparison of data. All analysis was carried out at significance of 0.05. Results: The mean age of patients in the treatment and control groups was 5.67± 2.82 and 6.94± 3.43 years, respectively (p=0.50). The symptoms of infectious mononucleosis e.g. fever, exudative erythema, tonsillitis, lymphadenopathy, tenderness, hepatomegaly and splenomegaly did not differ significantly between the two groups (p>0.05). In addition, the mean duration of hospitalization in the intervention and control groups was 4.23 ± 1.71 and 5.85 ± 7.27 days, respectively (p=0.65). Conclusion: The use of acyclovir-based regimens in the treatment of patients with infectious mononucleosis still depends on clinical suspicion and the experience of the treating physician, and its routine use is not recommended.