From the Guidelines
Mebendazole is the most cost-effective treatment for pinworms, typically available as a single 100mg dose that should be repeated after two weeks to kill any newly hatched worms. Although the provided evidence does not directly address the treatment of pinworms, the standard treatment approach in clinical practice is well-established.
- The treatment should be administered to all household members simultaneously, even if they don't have symptoms, to prevent reinfection.
- In addition to medication, thorough hygiene measures are essential, including:
- Washing all bedding, underwear, and pajamas in hot water
- Cleaning toilet seats and bathroom surfaces daily
- Vacuuming carpeted areas
- Practicing strict handwashing, especially after using the bathroom and before eating
- Keeping fingernails short and avoiding nail-biting to prevent reinfection. The medications work by either paralyzing the worms or disrupting their digestive processes, causing them to die and be eliminated from the body. The two-week follow-up dose is crucial because pinworm eggs can survive in the environment for up to three weeks, potentially causing reinfection 1.
From the FDA Drug Label
Mebendazole tablets are indicated for the treatment of Enterobius vermicularis (pinworm), Efficacy rates derived from various studies are shown in the table below: Pinworm (enterobiasis) Cure rates mean 95% For the treatment of pinworms.
Cost-effective treatment for pinworms is mebendazole (PO) with a cure rate of 95% 2.
- Mebendazole has a high cure rate for pinworms.
- Pyrantel pamoate (PO) is also indicated for the treatment of pinworms, but its efficacy rate is not provided 3.
From the Research
Cost-Effective Treatment for Pinworms
- The drugs of choice for the treatment of pinworm infestation are mebendazole (100 mg), pyrantel pamoate (11 mg/kg, maximum 1 g), and albendazole (400 mg), all of which are given in a single dose and repeated in two weeks 4.
- Mebendazole and albendazole are both adulticidal and ovicidal, whereas pyrantel pamoate is only adulticidal 4.
- Mass medication of affected groups with these anthelmintic therapies can reduce symptoms rapidly, progressively, and in a cost-effective way 5.
- Albendazole has been shown to have a high cure rate for pinworm infections, with a cure rate of 94.1% compared to 96.3% for pyrantel pamoate 6.
- A single 400 mg dose of albendazole has been found to be highly effective in treating nematode infections, including pinworms, in children 7.
Considerations for Treatment
- Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections, as reinfection is common even with effective medication 4.
- 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 4.
- For pregnant women, pyrantel is preferred to mebendazole and albendazole 4.