From the FDA Drug Label
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. When one individual in a household has pinworms, the entire household should be treated unless otherwise advised. Indications For the treatment of pinworms.
The recommended treatment for pinworm infection is a single dose of pyrantel pamoate with the following dosage:
- 5 milligrams of pyrantel base per pound of body weight
- 11 milligrams per kilogram of body weight
- Not to exceed 1 gram It is also recommended that the entire household be treated if one individual has pinworms, unless otherwise advised 1, 1.
From the Research
The recommended treatment for pinworm infection is an oral anthelmintic medication, typically mebendazole (100 mg once) or albendazole (400 mg once), with a second dose given two weeks later to prevent reinfection. Pyrantel pamoate (11 mg/kg, maximum 1 gram) is an effective over-the-counter alternative 2. All household members should be treated simultaneously since pinworm is highly contagious. In addition to medication, thorough hygiene measures are essential:
- wash hands frequently,
- keep fingernails short,
- shower daily,
- change underwear and bedding daily, and
- wash these items in hot water. These medications work by either paralyzing the worms or disrupting their ability to absorb nutrients, causing them to die and be eliminated from the body. The two-dose regimen is important because the medications kill adult worms but not eggs, which can hatch and cause reinfection. Most people experience complete resolution of symptoms after treatment, though reinfection is common, especially in children and institutional settings.
Given the high quality and recency of the study by 2, mebendazole and albendazole are currently the best available drugs for the treatment of pinworm infestation, due to their safety and effectiveness. For pregnant women, pyrantel is preferred to mebendazole and albendazole. Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections because reinfection is common even when effective medication is given.
Good personal hygiene, such as frequent handwashing, especially after bowel movements and before meals, clipping of fingernails, avoidance of finger-sucking, nail-biting, and scratching in the anogenital area, are important preventive measures 2. The diagnosis of E. vermicularis infection is best established by the cellophane tape test, with a sensitivity of approximately 90% with tests performed on three different mornings 2.
In terms of the choice of medication, mebendazole and albendazole are both adulticidal and ovicidal, whereas pyrantel pamoate is only adulticidal 2. The study by 2 provides the most up-to-date and comprehensive guidance on the treatment of pinworm infection, and its recommendations should be followed in clinical practice.