What is the first-line treatment for an immunocompetent adult with Herpes zoster?

The first-line treatment for immunocompetent adults with Herpes zoster, also known as shingles, involves antiviral medications that help to reduce the severity and duration of symptoms when initiated within 72 hours of the rash onset. Among the antiviral options available, famciclovir is an effective choice due to its ability to rapidly convert to its active form in the body and its good bioavailability. This translates into efficient viral suppression and symptom relief.

While acyclovir is also a commonly used antiviral for Herpes zoster, famciclovir is favored in this case due to its easier dosing regimen and favorable pharmacokinetics. Valacyclovir, another possible option, is a prodrug of acyclovir that offers the benefit of allowing for less frequent dosing, but famciclovir remains the more preferred first-line therapy.

Topical steroids do not address the underlying viral infection and are generally not recommended as primary treatment for Herpes zoster. Their use may actually be counterproductive by potentially exacerbating the infection or causing other complications. Therefore, famciclovir represents the optimal choice for managing Herpes zoster in immunocompetent adults.