Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact
the quality of life of affected patients. Different therapeutic approaches to treat
acute HZ are available. The aim of this European project was the elaboration of a
consensus-based guideline on the management of patients who present with HZ, considering
different patient populations and different localizations. This interdisciplinary
guideline aims at an improvement of the outcomes of the acute HZ management concerning
disease duration, acute pain and quality of life of the affected patients and at a
reduction in the incidence of postherpetic neuralgia (PHN) and other complications.
The guideline development followed a structured and pre-defined process, considering
the quality criteria for guidelines development as suggested by the AGREE II instrument.
The steering group was responsible for the planning and the organization of the guideline
development process (Division of Evidence-Based Medicine, dEBM). The expert panel
was nominated by virtue of clinical expertise and/or scientific experience and included
experts from the fields of dermatology, virology/infectiology, ophthalmology, otolaryngology,
neurology and anaesthesiology. Recommendations for clinical practice were formally
consented during the consensus conference, explicitly considering different relevant
aspects. The guideline was approved by the commissioning societies after an extensive
internal and external review process. In this second part of the guideline, therapeutic
interventions have been evaluated. The expert panel formally consented recommendations
for the treatment of patients with HZ (antiviral medication, pain management, local
therapy), considering various clinical situations. Users of the guideline must carefully
check whether the recommendations are appropriate for the context of intended application.
In the setting of an international guideline, it is generally important to consider
different national approaches and legal circumstances with regard to the regulatory
approval, availability and reimbursement of diagnostic and therapeutic interventions.