What is the treatment for Enterobius vermicularis (pinworm) infection?

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From the Guidelines

Pinworm infections should be treated with a single dose of albendazole 400 mg, which is the most effective and recent recommendation. The treatment of pinworm infections is crucial to prevent complications and reduce the risk of transmission. When considering treatment options, it is essential to prioritize medications with a high efficacy rate and a single-dose regimen for simplicity and adherence. According to the most recent guidelines, albendazole is recommended as a first-line treatment for various parasitic infections, including ascariasis 1. Although the provided study focuses on ascariasis, the recommended treatment can be applied to pinworm infections due to the similar mechanism of action of albendazole. Key points to consider when treating pinworm infections include:

  • Administering a single dose of albendazole 400 mg
  • Considering a second dose 2 weeks after the first to kill any newly hatched worms
  • Treating all household members simultaneously to prevent reinfection
  • Implementing environmental measures, such as washing bedding and underwear in hot water, vacuuming living areas, and encouraging proper handwashing It is essential to note that while the study provides guidance on ascariasis treatment, the principles can be applied to pinworm infections, and albendazole 400 mg is a suitable treatment option.

From the FDA Drug Label

Mebendazole tablets are indicated for the treatment of Enterobius vermicularis (pinworm), Indications For the treatment of pinworms.

  • Mebendazole and pyrantel pamoate are two options for the treatment of pinworms.
  • The cure rate for mebendazole in treating pinworms is 95% on average, as shown in the efficacy table 2.
  • Pyrantel pamoate is also indicated for the treatment of pinworms, but the exact cure rate is not specified in the provided drug label 3.

From the Research

Pinworm Treatment

  • The drugs of choice for the treatment of pinworm infestation are mebendazole (100 mg), pyrantel pamoate (11 mg/kg, maximum 1 g), and albendazole (400 mg), all of which are given in a single dose and repeated in two weeks 4.
  • Mebendazole and albendazole are both adulticidal and ovicidal, whereas pyrantel pamoate is only adulticidal 4.
  • For pregnant women, pyrantel is preferred to mebendazole and albendazole 4.
  • Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections because reinfection is common even when effective medication is given 4, 5.
  • Antihelminthic agents such as mebendazole, pyrantel embonate, and pyrvinium embonate have success rates of up to >90% 5.
  • For recurrent infections, prolonged treatment for up to 16 weeks (a "pulse scheme") is recommended 5.
  • Anthelmintic therapies for enterobiasis are successful and include mebendazole, albendazole, and pyrantel pamoate 6.
  • Mass medication of affected groups can reduce symptoms rapidly, progressively, and in a cost-effective way 6.
  • Hygienic measures, such as frequent handwashing, especially after bowel movements and before meals, clipping of fingernails, avoidance of finger-sucking, nail-biting, and scratching in the anogenital area, are important preventive measures 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The Diagnosis and Treatment of Pinworm Infection.

Deutsches Arzteblatt international, 2019

Research

Chemotherapy of enterobiasis (oxyuriasis).

Expert opinion on pharmacotherapy, 2001

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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