From the Guidelines
The recommended treatment for pinworm infection is a single dose of an anthelmintic medication such as mebendazole (100 mg), albendazole (400 mg), or pyrantel pamoate (11 mg/kg, maximum 1 gram). These medications should be repeated after two weeks to kill any newly hatched worms, as they don't kill eggs. For children under two years, pyrantel pamoate is often preferred. All household members should be treated simultaneously, even if asymptomatic, because pinworm is highly contagious. In addition to medication, thorough hygiene measures are essential:
- wash hands frequently,
- keep fingernails short,
- change and wash bedding and underwear daily in hot water,
- clean toilet seats regularly, and
- avoid scratching the anal area. These parasites spread through the fecal-oral route when eggs are ingested after being transferred from the anus to hands, food, or surfaces. The medications work by either paralyzing the worms or disrupting their ability to absorb nutrients, causing them to die and be expelled from the body. Most cases resolve completely with proper treatment and hygiene practices, as supported by recent guidelines 1. It's worth noting that while the provided evidence primarily discusses treatments for various parasitic infections, the recommended approach for pinworm infection aligns with standard medical practice, emphasizing the importance of both medication and hygiene in managing the infection.
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. 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 recommended treatment for pinworm (Enterobius vermicularis) infection is:
- Mebendazole (2)
- Pyrantel pamoate (3), with a single dose of 5 milligrams of pyrantel base per pound, or 11 milligrams per kilogram, of body weight not to exceed 1 gram. It is also advised that when one individual in a household has pinworms, the entire household should be treated unless otherwise advised.
From the Research
Pinworm Treatment
The recommended treatment for pinworm (Enterobius vermicularis) infection includes:
- Mebendazole (100 mg) given in a single dose and repeated in two weeks 4
- Pyrantel pamoate (11 mg/kg, maximum 1 g) given in a single dose and repeated in two weeks 4
- Albendazole (400 mg) given in a single dose and repeated in two weeks 4, 5, 6
Treatment Efficacy
The efficacy of these treatments has been studied in various trials:
- Mebendazole and albendazole have been shown to be effective against pinworm infection, with cure rates of 94.1% and 95.3%, respectively 5, 6
- Pyrantel pamoate has also been shown to be effective, with a cure rate of 96.3% 6
- Albendazole has been found to be effective against other intestinal helminthic infections, including hookworm and Ascaris lumbricoides 7, 5, 6
Special Considerations
- For pregnant women, pyrantel pamoate is preferred over mebendazole and albendazole 4
- Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections 4
- Good personal hygiene, such as frequent handwashing and avoidance of finger-sucking and nail-biting, is important for preventing reinfection 4