From the Guidelines
The best way to treat pinworms is with mebendazole, given its effectiveness and the recent guidelines supporting its use 1. The treatment of pinworms typically involves anthelmintic medications, and mebendazole is a commonly recommended option.
- The dosage for mebendazole is typically 100 mg taken orally once, with a second dose often recommended two weeks after the first to kill any newly hatched worms.
- It's essential to treat all household members simultaneously, even those without symptoms, as pinworm infections are highly contagious.
- In addition to medication, thorough hygiene measures should be implemented, including:
- Washing all bedding, underwear, and pajamas in hot water
- Cleaning toilet seats and bathroom surfaces daily
- Vacuuming carpeted areas
- Ensuring regular handwashing with soap, especially after using the bathroom and before eating
- Keeping fingernails short and avoiding nail-biting
- Showering each morning to remove eggs laid overnight Although the provided evidence primarily discusses the treatment of ascariasis, the recommended medications, such as mebendazole and albendazole, are also effective against pinworms, as supported by the most recent guidelines 1. However, it's crucial to note that the evidence provided does not directly address the treatment of pinworms, but mebendazole's effectiveness in treating similar parasitic infections makes it a suitable option. Given the lack of direct evidence on pinworm treatment in the provided studies, the recommendation is based on the most recent and highest-quality study available, which supports the use of mebendazole in treating parasitic infections 1.
From the FDA Drug Label
Mebendazole tablets are indicated for the treatment of Enterobius vermicularis (pinworm), Trichuris trichiura (whipworm), Ascaris lumbricoides (common roundworm), Ancylostoma duodenale (common hookworm), Necator americanus (American hookworm) in single or mixed infections. Efficacy rates derived from various studies are shown in the table below: Pinworm (enterobiasis) Cure rates mean 95% Adults, children 12 years of age and over, and children 2 years to under 12 years of age: Oral dosage is a single dose of 5 milligrams of pyrantel base per pound, or 11 milligrams per kilogram, of body weight not to exceed 1 gram. The best way to treat pinworms is with antiparasitic medications such as:
- Mebendazole (PO) with a cure rate of 95% 2
- Pyrantel pamoate (PO), with the entire household being treated unless otherwise advised 3
From the Research
Treatment Options for Pinworms
- 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.
Prevention of Pinworms
- Good personal hygiene, 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.
- Attention to hygienic measures can successfully eradicate pinworm infection and prevent recurrence and autoinfection 5.
Efficacy of Treatment Options
- Mebendazole, pyrantel embonate, and pyrvinium embonate have success rates of up to >90% in treating pinworm infestation 5.
- Albendazole and mebendazole are currently the best available drugs for the treatment of pinworm infestation due to their safety and effectiveness 4.
- Pyrantel pamoate has a wider applicability for poorer patients, despite being ineffective against trichurids and S. stercoralis 6.