Pinworm Treatment Regimen Using Syrup
The recommended treatment for pinworm infections is pyrantel pamoate syrup at a single dose of 11 mg/kg (not exceeding 1 gram), with a repeat dose in 2 weeks to prevent reinfection. 1, 2
Medication Options and Dosing
- Pyrantel pamoate syrup is administered as a single oral dose of 11 mg/kg (5 mg per pound) of body weight, not to exceed 1 gram total 1
- Alternative medications include:
- All treatments should be repeated after 2 weeks to eliminate newly hatched worms before they can lay eggs 3, 2
Dosing Guidelines for Pyrantel Pamoate Syrup
- For children under 25 lbs or under 2 years: Use only under physician direction 1
- For children 25-37 lbs: ½ teaspoonful 1
- For children 38-62 lbs: 1 teaspoonful 1
- For children 63-87 lbs: 1½ teaspoonful 1
- For children 88-112 lbs: 2 teaspoonful 1
- For children 113-137 lbs: 2½ teaspoonful 1
- For children 138-162 lbs: 3 teaspoonful 1
- For children 163-187 lbs: 3½ teaspoonful 1
- For adults and children over 188 lbs: 4 teaspoonful 1
Administration Guidelines
- Shake the medication well before use 1
- Can be taken any time of day, with or without meals 1
- May be taken alone or mixed with milk or fruit juice to improve palatability 1
- No laxative is necessary before, during, or after treatment 1
Treatment Considerations
- When one household member is infected, treat the entire household simultaneously to prevent reinfection 1, 2
- Mebendazole and albendazole are both adulticidal and ovicidal (kill both adult worms and eggs), while pyrantel pamoate is only adulticidal (kills only adult worms) 2
- For pregnant women, pyrantel pamoate is preferred over mebendazole and albendazole due to safety considerations 2
Hygiene Measures to Prevent Reinfection
- Implement frequent handwashing, especially after using the toilet and before eating 2
- Keep fingernails short and clean 2
- Discourage finger-sucking, nail-biting, and scratching in the perianal area 2
- Change and wash underwear, bedding, and pajamas daily during treatment 2
- Daily morning showers or baths to remove eggs deposited overnight 2
Treatment Success and Follow-up
- Success rates for recommended treatments are up to >90% when properly administered 4
- For recurrent infections, prolonged "pulse" treatment for up to 16 weeks may be necessary 4
- The cellophane tape test can be used to confirm clearance of infection, but a single negative test does not rule out ongoing infection 3, 2