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 (1)
- Pyrantel pamoate (2), 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. Key points:
- The entire household should be treated unless otherwise advised.
- If any symptoms or pinworms are still present after treatment, consult a physician.
From the Research
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), repeated after two weeks to prevent reinfection. This treatment approach is based on the most recent and highest quality study available, which emphasizes the importance of using these medications to effectively treat pinworm infections 3.
Key Considerations for Treatment
- The choice of medication depends on various factors, including the patient's age and weight, as well as any potential allergies or sensitivities to the medications.
- For children under two years, pyrantel pamoate is often preferred due to its safety profile and efficacy in this age group.
- All household members should be treated simultaneously, even if asymptomatic, because pinworm is highly contagious and reinfection can occur easily.
Importance of Hygiene Measures
In addition to medication, thorough hygiene measures are essential to prevent the spread of pinworm infection and reduce the risk of reinfection. These measures include:
- Washing hands frequently, especially after using the bathroom and before eating
- Keeping fingernails short to prevent scratching and subsequent ingestion of eggs
- Changing and washing bedding and underwear daily in hot water to kill any eggs that may be present
- Avoiding scratching the anal area to prevent further irritation and potential ingestion of eggs
- Cleaning bathroom surfaces regularly to reduce the risk of egg transmission
Rationale for Two-Week Interval
The two-week interval for the second dose of medication is critical because pinworm eggs can survive for up to three weeks in the environment, and the medication only kills adult worms, not eggs. By repeating the treatment after two weeks, any newly hatched worms can be effectively treated, reducing the risk of reinfection and ensuring that the infection is fully cleared 3.