Mebendazole for Deworming in Infants Over 1 Year Old
Yes, mebendazole can be given to infants over 1 year of age for deworming, but it is contraindicated in infants under 12 months of age. 1
Age-Based Recommendations
The Centers for Disease Control and Prevention explicitly advises against administering mebendazole to infants under 12 months of age. 1
For children 12 months and older, mebendazole is safe and effective for treating soil-transmitted helminth infections. 2
The FDA-approved indication for mebendazole includes treatment of pinworm, whipworm, roundworm, and hookworm infections, with efficacy rates ranging from 68% (whipworm) to 98% (roundworm). 3
Standard Dosing Regimens
For children ≥1 year old with helminth infections:
Standard dose: 100 mg twice daily for 3 consecutive days for most soil-transmitted helminth infections including Ascaris lumbricoides and Trichuris trichiura. 1, 4
Alternative single-dose regimen: 500 mg as a single dose for Ascaris infections, though the 3-day regimen is generally preferred for mixed infections. 1, 5
For a 14 kg child (approximately 1-2 years old), the recommended dose remains 100 mg twice daily for 3 days. 1
Administration Considerations
Critical safety point: Mebendazole tablets should be chewed for optimal absorption, not swallowed whole. 1
For children who cannot chew tablets, crush the tablet and mix with a small amount of food rather than water, as mixing with water significantly increases the risk of adverse swallowing events (34.6% vs 3.6% with whole tablets). 6
Avoid administering to children who are fussy, fearful, combative, or struggling, as non-content demeanor increases choking risk 20-fold. 6
Complete the full 3-day course even if symptoms improve, as premature discontinuation leads to treatment failure. 1
Efficacy by Parasite Type
Treatment effectiveness varies by helminth species:
Ascaris lumbricoides (roundworm): 98-100% cure rate with the standard 3-day regimen. 3, 4
Trichuris trichiura (whipworm): 68-75% cure rate, often requiring combination therapy with ivermectin for improved efficacy. 1, 3, 4
Hookworm (Ancylostoma/Necator): 96% cure rate with 99% egg reduction. 3
Enterobius vermicularis (pinworm): 95% cure rate. 3
When to Consider Re-treatment
In areas with high reinfection rates, re-treatment may be necessary after completing the initial course. 1
If stool examination remains positive 2-4 weeks after treatment, consider re-treatment or alternative agents like albendazole 400 mg single dose. 1
For whipworm infections with suboptimal response, combination therapy with ivermectin should be considered. 1
Common Pitfalls to Avoid
Do not use in infants <12 months: This is an absolute contraindication based on CDC guidelines. 1
Do not use in pregnant women: Mebendazole is contraindicated in pregnancy. 1
Do not give water immediately after or mixed with crushed tablets to young children, as this increases adverse swallowing events from 3.6% to 34.6%. 6
Do not assume single-dose therapy is adequate for all infections: While effective for Ascaris, mixed infections and whipworm require the full 3-day course. 1, 4
Mild diarrhea occurs in approximately 22% of children but is generally well-tolerated and does not require treatment discontinuation. 4