title: Comparison of Acyclovir and Famciclovir for Ramsay Hunt Syndrome.
abstract: Although antiviral agents are widely used to treat Ramsay hunt syndrome (RHS), their relative effectiveness has not been assessed. This study retrospectively compared clinical outcomes in patients with RHS treated with the antiviral agents acyclovir and famciclovir.
  
  
  
  This study involved 227 patients diagnosed with RHS from 2003 to 2015. Patients were treated with prednisolone plus acyclovir (n = 102) or famciclovir (n = 125). Patient outcomes were measured using the House-Brackmann scale according to age, initial severity of disease, electroneurography, and underlying disease.
  
  
  
  Based on complications (p = 0.019) and disease severity (p = 0.013), the overall complete recovery rate was significantly higher with famciclovir than with acyclovir, whereas rates of recovery in patients with severe (p = 0.111) and initially moderate (grades III-IV; p = 0.070) facial palsy were similar. Electroneurography also showed no difference in remission rate between the two groups (p = 0.692). Complete recovery rates in patients with hypertension and/or diabetes mellitus were similar in the two groups. However, the complete recovery rate of patients without hypertension and diabetes was significantly higher in patients treated with famciclovir than acyclovir (p = 0.018).
  
  
  
  Recovery rates in patients with RHS were higher following treatment with steroid plus famciclovir than with steroid plus acyclovir, especially in patients without hypertension and diabetes mellitus.
authors.affiliation: *Department of Otorhinolaryngology, Graduate School †Department of Anatomy and Neurobiology ‡Department of Biochemistry and Molecular Biology, Medical Science and Engineering Research Center for Bioreaction to Reactive Oxygen Species, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Ho Joong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Junyang
authors.initials: J
authors.lastname: Jung
authors.forename: Sung Su
authors.initials: SS
authors.lastname: Kim
authors.forename: Jae Yong
authors.initials: JY
authors.lastname: Byun
authors.forename: Moon Suh
authors.initials: MS
authors.lastname: Park
authors.forename: Seung Geun
authors.initials: SG
authors.lastname: Yeo
mesh_terms: D015075:2-Aminopurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000212:Acyclovir / Q000627:therapeutic use*; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005158:Facial Paralysis / Q000209:etiology; D000077595:Famciclovir; D005260:Female; D016697:Herpes Zoster Oticus / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D015075:2-Aminopurine; D011239:Prednisolone; D000077595:Famciclovir; D000212:Acyclovir