From the Guidelines
Seeing threadworms is sufficient evidence to treat, and the recommended treatment is albendazole PO 400 mg twice daily for 21 days, as per the latest guidelines 1. The presence of threadworms indicates an active infection, and prompt treatment is necessary to alleviate symptoms and prevent complications. According to the UK guidelines for the investigation and management of eosinophilia in returning travellers and migrants, published in the Journal of Infection in 2025 1, the treatment of choice for threadworm infection is albendazole. Key points to consider when treating threadworm infections include:
- The prepatent period of 2-6 weeks, during which the infection may not be symptomatic 1
- The potential for asymptomatic cases, with the most common symptom being pruritus ani 1
- The importance of monitoring liver function and full blood count during treatment with albendazole 1
- The need for strict hygiene measures to prevent reinfection, including washing hands thoroughly, keeping fingernails short, and avoiding scratching the anal area. It is essential to note that threadworms are highly contagious and can spread through eggs that can survive on surfaces for up to 2-3 weeks, making comprehensive treatment and hygiene crucial to prevent reinfestation.
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.
Seeing threadworms is enough evidence to treat for Enterobius vermicularis (pinworm) infection, as mebendazole is indicated for this condition 2.
- The presence of threadworms is a direct indication of infection.
- Mebendazole has a cure rate of 95% for pinworm (enterobiasis) 2.
From the Research
Diagnosis and Treatment of Threadworm Infection
- Seeing threadworms can be enough evidence to treat, as the presence of worms in the perianal area or stool can yield a definitive diagnosis 3, 4
- The cellophane tape test is also a common method for diagnosing threadworm infection, with a sensitivity of around 50% for a single test and up to 90% for tests performed on three different mornings 3
- Treatment options include mebendazole, pyrantel pamoate, and albendazole, which are given in a single dose and repeated in two weeks 3, 5, 6
- Good personal hygiene, such as frequent handwashing and clipping of fingernails, is also important in preventing reinfection 3, 7, 6
Importance of Household Treatment
- Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections, as reinfection is common even with effective medication 3, 7, 6
- Involvement of all persons living in the patient's household, including sexual partners, is a prerequisite to the lasting success of treatment 6