Oral ivermectin for treatment of pediculosis capitis.
BACKGROUND
Pediculosis capitis is a highly transmissible infestation prevalent worldwide. It is an important public health problem mainly affecting children. The emergence of drug resistance and high rates of treatment failure with several topical agents makes ivermectin, an antiparasitic drug, an attractive therapeutic option for lice control.


OBJECTIVE
To evaluate the efficacy and safety of oral ivermectin in the treatment of a pediatric population with pediculosis capitis.


METHODS
Children with pediculosis capitis from the ages of 6 to 15 years were recruited from an indigenous community in Mexico, and were treated with a single dose of oral ivermectin at 200 μg/kg. They were treated with a second dose of ivermectin 1 week later if there was evidence of persistent infestation.


RESULTS
Forty-four children (mean age, 9.8 years) with active infestation were treated. A single approximately 200-μg/kg dose of ivermectin eradicated adult lice in all children. Forty-one percent (n = 18) required a second dose because of the presence of viable nits. At the third visit, 2 weeks after commencement of treatment there was no evidence of viable nits, and there was complete resolution of excoriations in all children and minimal or no symptoms of pruritus were reported in 93% (n = 41). There were no significant adverse effects due to ivermectin administration.


CONCLUSIONS
Ivermectin demonstrates high efficacy and tolerability in the treatment of pediculosis capitis in children. A significant number of children required a second dose to ensure complete eradication.
Department of Dermatology, Royal Free Hampstead NHS Trust, London, United Kingdom. mahreenameen@hotmail.com
Mahreen
M
Ameen
Roberto
R
Arenas
Janeth
J
Villanueva-Reyes
Julieta
J
Ruiz-Esmenjaud
Daniel
D
Millar
Francisca
F
Domínguez-Dueñas
Alexandra
A
Haddad-Angulo
Mauricio
M
Rodríguez-Alvarez
D000284:Administration, Oral; D000293:Adolescent; D000818:Animals; D000977:Antiparasitic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D015331:Cohort Studies; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage* / Q000009:adverse effects; D010373:Lice Infestations / Q000188:drug therapy*; D008297:Male; D010374:Pediculus; D011446:Prospective Studies; D012536:Scalp Dermatoses / Q000188:drug therapy*
D000977:Antiparasitic Agents; D007559:Ivermectin