What is the treatment for enterobiasis (pinworm infection)?

From the Guidelines

The treatment for enterobiasis (pinworm infection) typically involves a single dose of albendazole (400 mg) or mebendazole (100 mg), with a second dose recommended 2 weeks after the initial treatment to kill any newly hatched worms and prevent reinfection, as supported by the most recent and highest quality study 1.

Key Points to Consider:

• The most effective treatment options for enterobiasis are albendazole and mebendazole, which work by either paralyzing the worms or disrupting their ability to absorb nutrients, causing them to die and be eliminated from the body.
• A single dose of albendazole (400 mg) or mebendazole (100 mg) is usually effective, but a second dose is often recommended 2 weeks after the initial treatment to kill any newly hatched worms and prevent reinfection.
• Household members should be treated simultaneously, as pinworm infections are highly contagious and can easily spread within families.
• In addition to medication, thorough hygiene measures are essential, including:
  • Washing hands regularly with soap and water, especially before eating and after using the bathroom
  • Keeping fingernails short and clean
  • Changing underwear and bedding daily
  • Washing bedding in hot water
  • Avoiding scratching the anal area
• These hygiene measures help prevent reinfection by breaking the cycle of egg ingestion that occurs when eggs from the perianal area are transferred to the mouth via contaminated hands or surfaces.

Additional Considerations:

• The diagnosis of enterobiasis is typically made using the "sellotape test", which involves placing the sticky side of sellotape on the perianal skin and then examining it under a microscope for ova, as described in 1.
• The treatment of enterobiasis should be guided by the most recent and highest quality evidence, which recommends the use of albendazole or mebendazole as the first-line treatment options, as supported by 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION The same dosage schedule applies to children and adults. The tablet may be chewed, swallowed, or crushed and mixed with food. Pinworm (enterobiasis)Whipworm (trichuriasis)Common Roundworm (ascariasis)Hookworm Dose1 tablet, once1 tablet morning and evening for 3 consecutive days1 tablet morning and evening for 3 consecutive days1 tablet morning and evening for 3 consecutive days If the patient is not cured three weeks after treatment, a second course of treatment is advised. INDICATIONS AND USAGE 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. The treatment for enterobiasis (pinworm infection) is mebendazole. The recommended dose is:

• 1 tablet for pinworm infection. It is also important to follow these rules to prevent reinfection:
• Wash hands and fingernails with soap often during the day, especially before eating and after using the toilet.
• Wear tight underpants both day and night.
• Change them daily.
• For several days after treatment, clean the bedroom floor by vacuuming or damp mopping.
• Avoid dry sweeping that may stir up dust
• After treatment, wash bed linens and night clothes (don’t shake them).
• Keep the toilet seats clean 2, 2, 2.

From the Research

Treatment Options for Pinworm Infection

The treatment for enterobiasis, also known as pinworm infection, typically involves the use of anthelmintic medications. The following are some of the treatment options:

• Mebendazole (100 mg) given in a single dose and repeated in two weeks 3
• Pyrantel pamoate (11 mg/kg, maximum 1 g) given in a single dose and repeated in two weeks 3
• Albendazole (400 mg) given in a single dose and repeated in two weeks 3

Considerations for Treatment

It is essential to consider the following when treating pinworm infection:

• Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections 3, 4
• Good personal hygiene, such as frequent handwashing, especially after bowel movements and before meals, is crucial in preventing reinfection 3
• Clipping of fingernails, avoidance of finger-sucking, nail-biting, and scratching in the anogenital area are also important preventive measures 3

Efficacy of Treatment Options

Studies have shown that the above-mentioned treatment options are effective in treating pinworm infection:

• Mebendazole and albendazole have been shown to have cure rates of up to 94.1% and 96.3%, respectively 5
• Pyrantel pamoate has also been shown to have a cure rate of up to 96.3% 5
• A study comparing the efficacy of albendazole, mebendazole, and ivermectin found that all three drugs were effective in treating Ascaris infection, with no significant differences in cure rates or adverse events 6

Special Considerations

In certain cases, special considerations need to be taken into account:

• For pregnant women, pyrantel is preferred to mebendazole and albendazole 3
• Treatment of pinworm infection in children and adults with confirmed infection has been shown to be safe and effective 6