What is the treatment for family members exposed to Enterobius vermicularis (pinworms)?

From the Guidelines

When family members are exposed to pinworms, all household members should be treated simultaneously with a single dose of albendazole 400 mg or mebendazole 100 mg, and a second dose should be given two weeks later to prevent reinfection from eggs that may have hatched after the initial treatment. This approach is based on the most recent and highest quality study available, which recommends albendazole 400 mg as a single dose for the treatment of pinworms 1. The treatment should be accompanied by thorough hygiene measures, including:

• Washing all bedding, underwear, and pajamas in hot water
• Vacuuming living areas
• Cleaning bathroom surfaces daily
• Ensuring regular handwashing, especially after using the toilet and before eating
• Keeping fingernails short
• Discouraging nail-biting and scratching around the anus These measures are necessary because pinworms spread easily through eggs that can survive on surfaces for up to three weeks, and reinfection is common without proper hygiene 1. The entire family requires treatment because pinworm eggs are highly contagious and can spread rapidly among household members, even before symptoms appear. It is also important to note that the prepatent period of pinworms is 2-4 weeks, and the mode of transmission is through the faeco-oral route 1.

From the FDA Drug Label

When one individual in a household has pinworms, the entire household should be treated unless otherwise advised. The treatment for family members exposed to pinworms is to treat the entire household with a medication such as pyrantel pamoate, unless otherwise advised by a physician 2.

• The dosage for pyrantel pamoate is a single dose of 5 milligrams of pyrantel base per pound, or 11 milligrams per kilogram, of body weight not to exceed 1 gram.
• Another option is mebendazole, which is indicated for the treatment of Enterobius vermicularis (pinworm) 3.

From the Research

Treatment for Family Members Exposed to Pinworms

• The treatment for pinworm infestation typically involves the use of anthelmintic medications such as mebendazole, albendazole, and pyrantel pamoate 4, 5, 6, 7.
• These medications are usually given in a single dose and repeated in two weeks to ensure the elimination of the parasites 4.
• Mebendazole and albendazole are both adulticidal and ovicidal, meaning they can kill both the adult worms and their eggs, while pyrantel pamoate is only adulticidal 4.
• Treatment of all household members is often recommended, especially if there are multiple or repeated symptomatic infections, as reinfection is common even with effective medication 4, 5.
• Good personal hygiene practices, such as frequent handwashing, clipping of fingernails, and avoidance of finger-sucking and nail-biting, are also important in preventing the spread of pinworms 4.

Considerations for Specific Individuals

• For pregnant women, pyrantel pamoate is often preferred over mebendazole and albendazole due to its safety profile 4.
• In cases of recurrent pinworm infection, intermittent administration of albendazole has been shown to be effective in preventing relapse 8.
• The choice of treatment may depend on the specific circumstances of the infection and the individual's medical history, and should be guided by a healthcare professional 6, 7.

Effectiveness of Treatment

• The cure rates for pinworm infection using albendazole and pyrantel pamoate have been reported to be high, with albendazole showing a cure rate of 94.1% and pyrantel pamoate showing a cure rate of 96.3% 6.
• Combination therapy with ivermectin and albendazole may also be effective in treating whipworm infections, although the cure rates can vary 6.
• Praziquantel is effective against most nematodes and trematodes, but its efficacy against tapeworm ranges from 75% to 85% 6, 7.