Enterobius vermicularis

Therapy

For typical pinworm infections, mebendazole can be used. This is given in single doses of 100 mg by mouth, repeated for two weeks to prevent reinfection, and is arguably the safest and most efficient therapy, with an efficacy of 96%. The drug targest adult worms, blocking glucose uptake and subsequently causing death. Albendazole may also be used in 100 mg doses for patients under two years old, or in doses of 400 mg for older patients. As in mebendazole, this should also be repeated for two weeks. Albendazole also targets adult worms, decreasing their ATP production and causing energy depletion, immobilization, and ultimately death.

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Pyrantel pamoate is also an option, and is given at 11 mg/kg, not to exceed 1 g. However, it can cause side effects, which include GI distress, neurotoxicity, and transient increases in liver enzymes. Pyrantel pamoate serves as a depolarizing neuromuscular blocking agent, inhibiting cholinesterases and resulting in spastic paralysis of the adult worms.

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Other drugs which have been used to treat pinworm infections include piperazine citrate, pyrvinium panoate, oxantel, oxantel-pyrantel, fenbendazole, and nitrazoxamide.

For pinworm infections of the genitourinary tract, mebendazole alone may be inadequate, and as such ivermectin is usually supplemented. Topical insecticides containing malathion or ivermectin may also be applied to the skin of the perineum in order to eliminate pinworm eggs.

In all cases of pinworm infection, treatment of the entire household is strongly suggested, whether or not symptoms are present. This is due to the fact that pinworms are easily transmitted among members of the household. Also, strict handwashing must be completed after using the toilet/changing the diaper of an infected baby, as well as before and after eating, for two weeks, bedding cleaned every 3-7 days for three weeks, and underwear and pajamas washed daily for two weeks.