Does oral aciclovir improve clinical outcome in immunocompetent children with primary herpes simplex gingivostomatitis?

A 3 year old previously well boy presents with a fever of 38.6ºc and several ulcers and erosions extending from his lips, along the tongue and cheek, to the back of the throat. The lesions have all appeared within the last 2 days. He has been crying inconsolably over the past 24 hours and is refusing food and drink. Is the use of oral aciclovir is indicated for primary herpes gingivostomatitis in children?

The question has been posed by a team from University Hospital of Wales, in Cardiff. It’s my belief that aciclovir works (based on clinical experience in children with malignant disease) – but the question of ‘is it indicated’ asks more than just ‘does it work’ but ‘should we use it’?

Any views out there?

(You can review the evidence in the report here.)

Acknowledgement:

Image from Wikipedia