title: Single application of 4% dimeticone liquid gel versus two applications of 1% permethrin creme rinse for treatment of head louse infestation: a randomised controlled trial.
abstract: BACKGROUND
  A previous study indicated that a single application of 4% dimeticone liquid gel was effective in treating head louse infestation. This study was designed to confirm this in comparison with two applications of 1% permethrin.
  
  
  METHODS
  We have performed a single centre parallel group, randomised, controlled, open label, community based trial, with domiciliary visits, in Cambridgeshire, UK. Treatments were allocated through sealed instructions derived from a computer generated list. We enrolled 90 children and adults with confirmed head louse infestation analysed by intention to treat (80 per-protocol after 4 drop outs and 6 non-compliant). The comparison was between 4% dimeticone liquid gel applied once for 15 minutes and 1% permethrin creme rinse applied for 10 minutes, repeated after 7 days as per manufacturer's directions. Evaluated by elimination of louse infestation after completion of treatment application regimen.
  
  
  RESULTS
  Intention to treat comparison of a single dimeticone liquid gel treatment with two of permethrin gave success for 30/43 (69.8%) of the dimeticone liquid gel group and 7/47 (14.9%) of the permethrin creme rinse group (OR 13.19, 95% CI 4.69 to 37.07) (p < 0.001). Per protocol results were similar with 27/35 (77.1%) success for dimeticone versus 7/45 (15.6%) for permethrin. Analyses by household gave essentially similar outcomes.
  
  
  CONCLUSIONS
  The study showed one 15 minute application of 4% dimeticone liquid gel was superior to two applications of 1% permethrin creme rinse (p < 0.001). The low efficacy of permethrin suggests it should be withdrawn.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN88144046.
authors.affiliation: Medical Entomology Centre, Insect Research & Development Limited, 6 Quy Court, Colliers Lane, Stow-cum-Quy, Cambridge CB25 9AU, UK. ian@insectresearch.com
authors.forename: Ian F
authors.initials: IF
authors.lastname: Burgess
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Brunton
authors.forename: Nazma A
authors.initials: NA
authors.lastname: Burgess
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004129:Dimethylpolysiloxanes / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D005782:Gels / Q000008:administration & dosage; D006801:Humans; D007306:Insecticides / Q000008:administration & dosage*; D010373:Lice Infestations / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010374:Pediculus; D026023:Permethrin / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004129:Dimethylpolysiloxanes; D005782:Gels; D007306:Insecticides; D026023:Permethrin; C501844:dimethicone
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