Treatment of Enterobiasis (Pinworm Infection)
The recommended first-line treatment for enterobiasis is a single 100 mg dose of mebendazole, which is highly effective with cure rates of approximately 95%. 1
Medication Options
First-line Treatment:
- Mebendazole: 100 mg as a single dose 1, 2
- The tablet may be chewed, swallowed, or crushed and mixed with food
- No special procedures such as fasting or purging are required
Alternative Treatment:
- Albendazole: 400 mg as a single dose 1
- Equally effective as mebendazole
Treatment Protocol
Standard Protocol:
- Administer single dose of mebendazole 100 mg or albendazole 400 mg
- Repeat the same dose after 2-3 weeks to eradicate any newly hatched parasites
- If not cured three weeks after treatment, a second course of treatment is advised 2
Special Situations:
- For recurrent infections: Consider three courses of treatment at 3-week intervals 3
- For family/institutional outbreaks: Treat all household members simultaneously to prevent reinfection 4
Diagnosis Confirmation
- Sellotape test: The definitive diagnostic method involves placing adhesive tape on the perianal skin in the morning before bathing or defecation, then examining under microscope for ova 1
- Eggs are typically not found in stool samples
Additional Management Considerations
Hygiene Measures (Essential for preventing reinfection):
- Daily morning shower to remove eggs
- Regular changing and washing of underwear, bedding, and pajamas in hot water
- Regular cleaning of toilet seats and bathroom surfaces
- Keeping fingernails short and avoiding nail-biting
- Thorough handwashing, especially after using the toilet and before eating
Monitoring:
- Perform follow-up sellotape test 2-3 weeks after treatment to confirm cure
- Monitor for symptom resolution (particularly perianal itching)
Special Considerations
- Ectopic infections: Enterobius vermicularis can occasionally migrate to the female genital tract causing symptoms that may mimic other conditions like endometriosis 3, 5
- Pregnancy: Consult with specialist before administering treatment
- Immunocompromised patients: May require more aggressive treatment and follow-up
Treatment Efficacy
Mebendazole has demonstrated excellent efficacy against Enterobius vermicularis with cure rates of approximately 95% 1, 4. The medication works by blocking the microtubule systems of parasites, inhibiting glucose uptake and transport, ultimately leading to parasite death 6.
The high efficacy, safety profile, and simple dosing regimen make mebendazole the treatment of choice for enterobiasis in both individual cases and community settings.