Parapoxviruses Medication

Updated: Oct 07, 2015
  • Author: Luke Bloomquist, MD; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to eradicate the infection, reduce morbidity, and prevent complications.

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Antiviral agents

Class Summary

Therapy of viral infections begins with mechanical debridement of the involved rim and a rim of normal epithelium. This is followed by the topical instillation of antiviral medications.

Cidofovir (Vistide)

Currently approved for treatment of CMV retinitis in AIDS. Cidofovir is the first member of a group of antivirals known as acyclic phosphonate nucleotide analogs. Cidofovir diphosphate, the active intracellular metabolite of cidofovir inhibits herpes virus polymerases at concentrations that are 8- to 600-fold lower than those needed to inhibit human cellular DNA polymerases alpha, beta, and gamma. Incorporation of cidofovir into the growing viral DNA chain results in reductions in the rate of viral DNA synthesis.

Several small studies and case reports have demonstrated eradication of parapoxvirus or other virally induced cutaneous diseases resistant to usual treatment modalities. Although a topical formulation is not currently commercially available from the manufacturer, it is possible to obtain topical cidofovir cream prepared by a pharmacist.

Idoxuridine (Herplex, Dendrid)

One of the first halogenated pyrimidine derivatives used for their antiviral effect. Used primarily in herpetic keratitis but was replaced by newer better-tolerated agents and for epithelial infections (especially initial attacks). Infections characterized by the presence of a dendritic shape respond better to this medication than stromal infections. Blocks reproduction of herpes simplex virus by producing incorrect DNA copies, preventing the virus from infecting or destroying tissue.

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Immunomodulators

Class Summary

These agents modulate immune reactions resulting from diverse stimuli.

Imiquimod (Aldara, Zyclara)

Induces secretion of IFN-alfa and other cytokines. Mechanisms of action are unknown. May be more effective in women than in men.

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