What is a one-time medication for pinworm (enterobiasis) infection?

One-Time Pinworm Medication

For pinworm (enterobiasis) infection, give either albendazole 400 mg or mebendazole 100 mg as a single oral dose, with a mandatory repeat dose in 2 weeks to eradicate newly hatched worms. 1

Medication Options

Both medications are equally effective and safe, with standardized dosing across all age groups including young children:

• Albendazole 400 mg: Single oral dose, repeated in 2 weeks 1, 2

  • Cure rate of 100% for enterobiasis 3
  • Both adulticidal and ovicidal 4
  • FDA-approved for pinworm treatment 2

• Mebendazole 100 mg: Single oral dose (one tablet), repeated in 2 weeks 1, 5

  • Cure rate of 95% for enterobiasis 5, 3
  • Both adulticidal and ovicidal 4
  • Can be chewed, swallowed, or crushed and mixed with food 5

Critical Treatment Considerations

The 2-week repeat dose is mandatory, not optional. 1 This timing targets newly hatched worms from eggs that survived the initial treatment, as the medications kill adult worms but may not eliminate all eggs. 1

Treat all household members simultaneously, especially when multiple or repeated symptomatic infections occur, as reinfection rates are extremely high even with effective medication. 4, 6 Sexual partners should also be included in treatment. 6

Dosing Across Age Groups

The same dose applies universally:

• Adults and children: Albendazole 400 mg or mebendazole 100 mg 1
• Children as young as 2 years: Same standardized dose 1
• Children 12-24 months: Consult specialist before treatment 2

Special Populations

Pregnant women: Pyrantel pamoate is preferred over mebendazole and albendazole due to safety concerns. 4 Do not take mebendazole if pregnant or possibly pregnant. 5

Essential Hygiene Measures

Medication alone is insufficient due to high reinfection rates. Implement these measures concurrently with treatment:

• Wash hands and fingernails with soap frequently, especially before eating and after using the toilet 5
• Wear tight-fitting underwear day and night, change daily 5
• Clean bedroom floors by vacuuming or damp mopping for several days after treatment (avoid dry sweeping) 5
• Wash bed linens and nightclothes after treatment without shaking them 5
• Keep toilet seats clean 5
• Clip fingernails short and avoid nail-biting, finger-sucking, and scratching the perianal area 4

Common Pitfalls

Recurrence is common and usually represents reinfection rather than treatment failure, given the short life span of adult pinworms and ease of autoinfection. 4 For recurrent infections despite proper treatment and hygiene, consider prolonged "pulse scheme" treatment for up to 16 weeks. 6

No special procedures required: Fasting or purging is unnecessary before or after treatment. 5

Stool examination is not useful for diagnosis, as pinworms and eggs are not usually passed in stool. 1 The cellophane tape test applied to perianal skin in the morning before bathing is the preferred diagnostic method. 1