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__NOTOC__ | |||
{{Enterobiasis}} | |||
{{CMG}} {{AE}} {{MMF}} | |||
==Overview== | |||
[[Antiparasitics|Antiparasitic drugs]] used for enterobiasis include either [[mebendazole]] (Vermox), [[albendazole]], [[piperazine]] (Antepar), or [[pyrantel pamoate]] (Combatrin, Povan). A repeat dose is recommended two weeks after the initial treatment. More than one household member is likely to be infected, so the entire household is often treated. | |||
==Medical Therapy== | |||
*[[Medication]] is the primary treatment for pinworm infection. However, reinfection is frequent regardless of the medication used. Also, if one household member spreads the eggs to another, it will be a matter of two or three weeks before those eggs become adult worms and thus amenable to treatment. | |||
*[[Asymptomatic]] infections, often in small children, can serve as reservoirs of infection, and therefore the entire household should be treated regardless of whether or not symptoms are present. Total elimination of the parasite in a household may require repeated doses of medication for up to a year or more. Because the drugs kill the adult pinworms, but not the eggs, the first retreatment is recommended in two weeks. | |||
*The medications usually used for the treatment of pinworm are: | |||
**[[Mebendazole]] | |||
**[[Pyrantel pamoate]] | |||
**[[Albendazole]] | |||
== | ===Antimicrobial Regimen=== | ||
The | *''' Enterobius vermicularis'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref> | ||
:* Preferred regimen (1): [[Albendazole]] 400 mg PO single dose | |||
:* Preferred regimen (2): [[Mebendazole]] 100 mg PO single dose | |||
:* Preferred regimen (3): [[Ivermectin]] 200 µg/kg PO single dose | |||
:* Preferred regimen (4): [[Pyrantel pamoate]] 11 mg/kg up to 1.0 g PO single dose | |||
*Note: A second dose is given 2 weeks later. The second dose of medication is to eliminate possible re-infection or autoinfection. Health risks and benefits of these drugs for patients under 2 years of age should be considered. | |||
===Mechanism of action=== | |||
#Benzimidazole compounds | |||
#*The [[benzimidazole]] compounds [[albendazole]] (brand names e.g., ''Albenza'', ''Eskazole'', ''Zentel'' and ''Andazol'') and [[mebendazole]] (brand names e.g., ''Ovex'', ''Vermox'', ''Antiox'' and ''Pripsen'') are the most effective. They work by inhibiting the [[microtubule]] function in the pinworm adults, causing [[glycogen]] depletion, thereby effectively starving the parasite. A single 100-milligram dose of [[mebendazole]] with one repetition after a week is considered the safest and is usually effective with a cure rate of 96%. Mebendazole has no serious [[side effects]], although [[abdominal pain]] and [[diarrhea]] have been reported. | |||
#Pyrantel pamoate | |||
#*[[Pyrantel pamoate]] (also called pyrantel embonate, brand names e.g., ''Reese's Pinworm Medicine'', ''Pin-X'', ''Combantrin'', ''Anthel'', ''Helmintox'', and ''Helmex'') kills adult pinworms through the neuromuscular blockade and is considered as effective as the [[benzimidazole]] compounds. | |||
#Other medications | |||
#*[[Piperazine]] causes [[flaccid paralysis]] in the adult pinworms and pyrvinium pamoate (also called pyrvinium embonate) works by inhibiting [[oxygen]] uptake of the adult pinworms. | |||
Pinworms located in the [[genitourinary system]] (in this case, female genital area) may require other drug treatments. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Parasites]] | [[Category:Parasites]] | ||
[[Category:Nematodes]] | [[Category:Nematodes]] | ||
[[Category:Proctology]] | [[Category:Proctology]] | ||
[[Category:Pediatrics]] | |||
[[Category:Emergency medicine]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category: | [[Category:Gastroenterology]] | ||
Latest revision as of 21:35, 29 July 2020
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Enterobiasis Microchapters |
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Enterobiasis medical therapy On the Web |
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Risk calculators and risk factors for Enterobiasis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]
Overview
Antiparasitic drugs used for enterobiasis include either mebendazole (Vermox), albendazole, piperazine (Antepar), or pyrantel pamoate (Combatrin, Povan). A repeat dose is recommended two weeks after the initial treatment. More than one household member is likely to be infected, so the entire household is often treated.
Medical Therapy
- Medication is the primary treatment for pinworm infection. However, reinfection is frequent regardless of the medication used. Also, if one household member spreads the eggs to another, it will be a matter of two or three weeks before those eggs become adult worms and thus amenable to treatment.
- Asymptomatic infections, often in small children, can serve as reservoirs of infection, and therefore the entire household should be treated regardless of whether or not symptoms are present. Total elimination of the parasite in a household may require repeated doses of medication for up to a year or more. Because the drugs kill the adult pinworms, but not the eggs, the first retreatment is recommended in two weeks.
- The medications usually used for the treatment of pinworm are:
Antimicrobial Regimen
- Enterobius vermicularis[1]
- Preferred regimen (1): Albendazole 400 mg PO single dose
- Preferred regimen (2): Mebendazole 100 mg PO single dose
- Preferred regimen (3): Ivermectin 200 µg/kg PO single dose
- Preferred regimen (4): Pyrantel pamoate 11 mg/kg up to 1.0 g PO single dose
- Note: A second dose is given 2 weeks later. The second dose of medication is to eliminate possible re-infection or autoinfection. Health risks and benefits of these drugs for patients under 2 years of age should be considered.
Mechanism of action
- Benzimidazole compounds
- The benzimidazole compounds albendazole (brand names e.g., Albenza, Eskazole, Zentel and Andazol) and mebendazole (brand names e.g., Ovex, Vermox, Antiox and Pripsen) are the most effective. They work by inhibiting the microtubule function in the pinworm adults, causing glycogen depletion, thereby effectively starving the parasite. A single 100-milligram dose of mebendazole with one repetition after a week is considered the safest and is usually effective with a cure rate of 96%. Mebendazole has no serious side effects, although abdominal pain and diarrhea have been reported.
- Pyrantel pamoate
- Pyrantel pamoate (also called pyrantel embonate, brand names e.g., Reese's Pinworm Medicine, Pin-X, Combantrin, Anthel, Helmintox, and Helmex) kills adult pinworms through the neuromuscular blockade and is considered as effective as the benzimidazole compounds.
- Other medications
- Piperazine causes flaccid paralysis in the adult pinworms and pyrvinium pamoate (also called pyrvinium embonate) works by inhibiting oxygen uptake of the adult pinworms.
Pinworms located in the genitourinary system (in this case, female genital area) may require other drug treatments.
References
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.