title: Controlled study of malathion and d-phenothrin lotions for Pediculus humanus var capitis-infested schoolchildren.
abstract: Anecdotal reports have suggested that reduced efficacy of pediculicides against Pediculus humanus capitis could be related to resistance to treatments. Ovicidal and pediculicidal activities of 0.5% malathion and 0.3% d-phenothrin lotions were tested in an experimental model of P humanus capitis grown on rabbits to ensure that the two treatments were pharmacologically equipotent. We then did a randomised controlled trial in which the lotions were administered to 193 P humanus capitis-infested schoolchildren (malathion, 95; d-phenothrin, 98). Success rate was defined as the absence of both live lice and viable nits. Before treatment, live lice were collected and subjected to a pediculicidal test. Pharmacological tests showed 100% killing of the rabbit-grown nits and lice after exposure to both pediculicides. On day 1 of the controlled trial, the success rate was 92% in the malathion group (95% CI, 0.86-0.97) and 40% in the d-phenothrin group (0.30-0.49) (p < 0.0001); on day 7, it was 95% in the malathion group (0.90-0.99) and 39% in the d-phenothrin group (0.29-0.48, p < 0.0001). Malathion was also significantly more active in the pediculicidal tests compared to d-phenothrin and control. These results suggest an acquired resistance to d-phenothrin in the schoolchildren tested, since all other conditions of the administration of insecticides were standardised.
authors.affiliation: Service de Médecine Interne, Hôpital de la Salpêtrière, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Chosidow
authors.forename: C
authors.initials: C
authors.lastname: Chastang
authors.forename: C
authors.initials: C
authors.lastname: Brue
authors.forename: E
authors.initials: E
authors.lastname: Bouvet
authors.forename: M
authors.initials: M
authors.lastname: Izri
authors.forename: N
authors.initials: N
authors.lastname: Monteny
authors.forename: S
authors.initials: S
authors.lastname: Bastuji-Garin
authors.forename: J J
authors.initials: JJ
authors.lastname: Rousset
authors.forename: J
authors.initials: J
authors.lastname: Revuz
mesh_terms: D000818:Animals; D002648:Child; D005260:Female; D006801:Humans; D007305:Insecticide Resistance; D010373:Lice Infestations / Q000188:drug therapy*; D008294:Malathion / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D010374:Pediculus / Q000187:drug effects; D011722:Pyrethrins / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D011817:Rabbits; D012536:Scalp Dermatoses / Q000188:drug therapy*
chemical_list: D011722:Pyrethrins; C006166:phenothrin; D008294:Malathion