Topical cidofovir for treatment of resistant viral infections.

Cidofovir is a broad-spectrum antiviral agent with activity against several DNA viruses. An application to approve the use of topical cidofovir for acyclovir-resistant herpes virus infection was denied by the US Food and Drug Administration owing to the lack of phase III clinicla trial data. The manufacturer stated that, as of 1997, no further controlled studies were planned or in progress to evaluate topical cidofovir in herpes simplex infections. It is unknown whether there are plans to conduct controlled studies of topical cidofovir for HPV or MVC infections. However, numerous case reports and published studies describe successful use of topical cidofovir to treat resistant and severe forms of viral infections such as molluscum contagiosum, condylomata acuminata, verruca vulgaris, herpes simplex virus infection, genital warts, and ginigval infection with human papillomavirus. Because of the mutagenic properties of cidofovir, compounding the preparation is considered hazardous. Since most retail pharmacies do no have the safety equipment necessary to compound hazardous preparations, a compounding pharmacist can play a vital role in preparing topical cidofovir cream or gel.