RISK FACTORS: Institutionalization (50-90% of institutionalized children have pinworms),
Crowded living conditions, Poor hygiene, Warm climate
GENERAL MEASURES
β’ All symptomatic family members should be treated simultaneously
β’ Bedclothes and underwear of infected individuals should be washed in hot water at the time of treatment
(ova can remain viable for 2-3 weeks in a moist environment)
β’ Strict hand washing can help prevent fecal-oral transmission
β’ Practice good hygiene (showers, nail cleaning)
β’ Topical use of antipruritic creams or ointments may help relive itching in the perianal region
DRUG(S) OF CHOICE
β’ Some clinicians recommend repeat treatment after 2 weeks. Occasionally, recalcitrant cases may require
retreatment every 2 weeks for 4-6 cycles. Choose one of the following:
β’ Mebendazole (Vermox) chewable tablet 100 mg as a single dose. Use with caution in children < age 2
β’ Albendazole 400 mg orally as a single dose
β’ Pyrantel pamoate (Antiminth) oral suspension 11 mg/kg as a single dose. Maximum dose 1 gram. Use with
caution in children < age 2
PATIENT MONITORING Unnecessary unless symptoms do not abate following drug therapy
PREVENTION/AVOIDANCE
β’ Careful hand washing, keep nails short and clean
β’ Wash anus and genitals at least once a day, preferably in a shower
β’ Donβt scratch anus or put fi ngers near nose or mouth
POSSIBLE COMPLICATIONS
β’ Perianal scratching may cause impetigo or excoriation
β’ Young girls - vulvovaginitis, urethritis, endometritis, salpingitis
β’ Urinary tract infections
EXPECTED COURSE/PROGNOSIS
β’ Asymptomatic carriers are common
β’ Symptomatic infections are cured > 90% of the time with drug therapy
β’ Reinfection is common