From the Guidelines
Albendazole is the most suitable alternative to mebendazole for treating enterobiasis (pinworm infection), given as a single 400mg oral dose, repeated after 2 weeks to kill newly hatched worms. This recommendation is based on the most recent and highest quality study available, which suggests that albendazole is a effective treatment for enterobiasis 1. Other alternatives, such as pyrantel pamoate and ivermectin, may also be considered, but albendazole is the preferred choice due to its efficacy and safety profile.
Key Points to Consider
- Treatment should include all household members simultaneously to prevent reinfection, as pinworms are highly contagious.
- Environmental measures are important: washing bedding and underwear in hot water, daily showering (especially in the morning to remove eggs), keeping fingernails short, avoiding nail-biting, and thorough handwashing.
- These medications are generally well-tolerated with minimal side effects, making them suitable alternatives when mebendazole is unavailable, contraindicated, or not preferred.
Medication Options
- Albendazole: 400mg oral dose, repeated after 2 weeks
- Pyrantel pamoate: 11mg/kg (maximum 1g) oral dose, repeated after 2 weeks
- Ivermectin: 200mcg/kg oral dose, repeated after 2 weeks It is essential to note that the treatment of enterobiasis should be guided by the most recent and highest quality evidence available, and albendazole is the recommended alternative to mebendazole based on the current evidence 1.
From the Research
Alternatives to Mebendazole for Pinworm Infection
- Pyrantel pamoate is an alternative to mebendazole for treating enterobiasis (pinworm infection), with a single dose of 11 mg/kg (maximum 1 g) repeated in two weeks 2.
- Albendazole is also an effective alternative, given in a single dose of 400 mg repeated in two weeks 2.
- Both mebendazole and albendazole are adulticidal and ovicidal, whereas pyrantel pamoate is only adulticidal 2.
Comparison of Alternatives
- A study comparing the efficacy of mebendazole, pyrvinium pamoate, and pyrantel pamoate found that pyrantel pamoate had the earliest and most remarkable positive conversion, while mebendazole had the slowest and least remarkable conversion 3.
- Another study found that albendazole had a cure rate of 94.1% for pinworm, while pyrantel pamoate had a cure rate of 96.3% 4.
Considerations for Treatment
- Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections, due to the high risk of reinfection 2.
- Good personal hygiene, such as frequent handwashing and avoidance of finger-sucking and nail-biting, is important for preventing reinfection 2.
- For pregnant women, pyrantel pamoate is preferred over mebendazole and albendazole 2.