eMedicine Specialties > Pediatrics: General Medicine > Parasitology
Enterobiasis: Treatment & Medication
Updated: Nov 16, 2007
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Treatment
Medical Care
- Fear, disgust, and guilt are common parental reactions to parasitic worm infestation. Many families present to the emergency department or their pediatrician with misconceptions about pinworms. In addition to prescribing medications, educating families about pinworms (see Patient Education) is helpful.
- Thorough and regular handwashing is effective in preventing disease transmission.
Medication
Mebendazole or albendazole are recommended as first-line treatment of pinworms. A second dose given 2 weeks after the initial dose helps prevent reoccurrences from reinfection.
Because asymptomatic infestation of other members in a household is frequent, simultaneously treating all household members may be reasonable. Families should be informed that repeat infestations are common. Reinfestation is treated with the same medications as the initial infestation.
Symptomatic relief of pruritus can be obtained by applying an antipruritic ointment or cream topically to the affected (usually perianal) region.
Anthelmintics
Parasite biochemical pathways are different from the human host, thus toxicity is directed to the parasite, egg, or larvae. Mechanism of action varies within the drug class.
Pyrantel (Antiminth, Pin-Rid, Pin-X)
Depolarizing neuromuscular blocking agent and inhibits cholinesterases, resulting in spastic paralysis of the worm. Purging not necessary. May be taken with milk or fruit juices.
Adult
11 mg/kg PO once; not to exceed 1 g; repeat treatment in 2 wk
Pediatric
Administer as in adults
Theophylline serum levels may increase in pediatric patients, following pyrantel pamoate administration
Documented hypersensitivity; hepatic disease
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Caution in liver impairment, anemia, or malnutrition
Mebendazole (Vermox)
Causes worm death by selectively and irreversibly blocking uptake of glucose and other nutrients in susceptible adult intestine where helminths dwell.
Adult
100 mg PO once; repeat treatment in 2 wk
Pediatric
Administer as in adults
Carbamazepine and phenytoin may decrease effects of mebendazole; cimetidine may increase mebendazole levels
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Adjust dose in hepatic impairment
More on Enterobiasis |
| Overview: Enterobiasis |
| Differential Diagnoses & Workup: Enterobiasis |
Treatment & Medication: Enterobiasis |
| Follow-up: Enterobiasis |
| References |
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References
Arca MJ, Gates RL, Groner JI, Hammond S, Caniano DA. Clinical manifestations of appendiceal pinworms in children: an institutional experience and a review of the literature. Pediatr Surg Int. May 2004;20(5):372-5. [Medline].
American Academy of Pediatrics. Pinworm Infection (Enterobius vermicularis). Report of the committee on infectious disease. 2003;486-7.
Hoekelman RA. Pinworm Infestation. In: Merck Manual of Diagnosis and Therapy. 15th ed. 1987.
Kucik CJ, MartinGL, Sortor BV. Common Intestinal Parasites. Am Fam Physician. Mar 2004;69(5):11621-8.
Lormans JA, Wesel AJ, Vanprus OF. Mebendazole in enterobiasis. A clinical trial in mental retardates. Chemotherapy. 1975;21:255.
Song HJ, Cho CH, Kim JS, et al. Prevalence and risk factors for enterobiasis among preschool children in a metropolitan city in Korea. Parasitol Res. Sep 2003;91(1):46-50. [Medline].
Symmers WS. Pathology of oxyuriasis; with special reference to granulomas due to the presence of Oxyuris vermicularis (Enterobius vermicularis) and its ova in the tissues. AMA Arch Pathol. Oct 1950;50(4):475-516. [Medline].
Weller TH, Sorenson CW. Enterobiasis: Its incidence and symptomatology in a group of 505 children. NEJM. 1941;224:143.
Further Reading
Keywords
enterobiasis, pinworms, oxyuriasis, Enterobius vermicularis, E vermicularis, human pinworm, pinworm infection, pruritus ani, pruritus vulvae, vaginitis
Treatment & Medication: Enterobiasis