trimethoprim--sulfamethoxazole-drug-combination and Lice-Infestations

Head lice infestations continue to be seen frequently in many communities. Some of these children require multiple treatments before eradication. What are the current treatment recommendations for head lice?. Head lice (Pediculus humanus capitis) infestations are common, particularly among school-aged children. In order to minimize louse resistance, insecticide usage, and social stigmatization, diagnosis and treatment should be limited to those with live lice on the scalp. Options for management are predominantly topical therapies or physical removal. Large studies comparing the efficacy of these treatments are lacking. Treatment should be repeated in approximately 7 days if topical insecticides are used or every 2 to 3 days for 2 weeks if wet combing is used. Lice resistance patterns vary widely geographically, and resistance is now the most common cause of treatment failure.

Topics: Animals; Anthelmintics; Anti-Infective Agents; Child; Humans; Insecticides; Ivermectin; Lice Infestations; Pediculus; Pyrethrins; Scalp Dermatoses; Trimethoprim, Sulfamethoxazole Drug Combination

Head lice can only be diagnosed by finding live lice, as eggs take 7 days to hatch and may appear viable for weeks after death of the egg. Infestation may be more likely in school children, with risks increased in children with more siblings, longer hair, and of lower socioeconomic group.. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for head lice? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).. We found 26 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.. In this systematic review, we present information relating to the effectiveness and safety of the following interventions: benzyl alcohol, dimeticone, herbal and essential oils, insecticide combinations, isopropyl myristate, ivermectin, lindane, malathion, mechanical removal by combing ("bug busting"), oral trimethoprim-sulfamethoxazole (co-trimoxazole, TMP-SMX), permethrin, phenothrin, pyrethrum, and spinosad.

Topics: Animals; Humans; Lice Infestations; Pediculus; Permethrin; Scalp Dermatoses; Trimethoprim, Sulfamethoxazole Drug Combination

Head lice can only be diagnosed by finding live lice, as eggs take 7 days to hatch and may appear viable for weeks after death of the egg. Infestation may be more likely in school children, with risks increased in children with more siblings, longer hair, and of lower socioeconomic group.. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for head lice? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).. We found 15 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.. In this systematic review we present information relating to the effectiveness and safety of the following interventions: dimeticone, herbal and essential oils, insecticide combinations, lindane, malathion, mechanical removal by combing ('bug busting'), oral trimethoprim-sulfamethoxazone (co-trimoxazole, TMP-SMX), permethrin, phenothrin, and pyrethrum.

Topics: Administration, Oral; Animals; Humans; Lice Infestations; Malathion; Pediculus; Permethrin; Scalp Dermatoses; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Administration, Cutaneous; Administration, Oral; Animals; Anti-Infective Agents; Child; Dermatologic Agents; Drug Therapy, Combination; Hexachlorocyclohexane; Humans; Insecticides; Ivermectin; Lice Infestations; Malathion; Pediculus; Permethrin; Pesticide Synergists; Piperonyl Butoxide; Pyrethrins; Sarcoptes scabiei; Scabies; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Total of 7,495 children including 3,908 boys and 3,587 girls from a kindergarten and 15 primary schools were examined for head lice infestation (HLI). The overall prevalence of HLI in this study was found to be 5.8%. Head lice were much more commonly detected in girls than in boys with prevalence of 11.2% and 0.9%, respectively. Sixty-nine children with HLI were treated with 1% lindane shampoo alone (group 1), and 45 children with HLI were treated with 1% lindane shampoo and oral trimethoprim/sulfamethoxazole (group 2), and follow-up visits were conducted 2 and 4 weeks later. The children who still had HLI 2 weeks after the primary treatment were treated again. At the 2-week follow-up visit, the treatment success rates of groups 1 and 2 were 76.8% and 86.7%, respectively, and at the 4-week follow-up visit, the rates were 91.3% and 97.8%, respectively. No statistically significant synergistic effect was observed for the combination of a 1% lindane shampoo and oral trimethoprim/sulfamethoxazole.

Topics: Animals; Anti-Infective Agents; Child; Drug Therapy, Combination; Female; Hair Preparations; Health Surveys; Hexachlorocyclohexane; Humans; Korea; Lice Infestations; Male; Pediculus; Prevalence; Students; Trimethoprim, Sulfamethoxazole Drug Combination

Head lice infestation (HLI) is a vexing problem for pediatricians and families because lice are becoming resistant to approved antipediculosis agents.. This study compared the efficacy of 3 different treatments for HLI and determined whether combination therapy reduced treatment failures.. A randomized, clinical trial performed in 3 private practices.. The population was children ranging in age from 2 to 13 years.. HLI was diagnosed by direct inspection of the hair and scalp. Children were assigned to 1 of 3 groups: 1) 1% permethrin creme rinse (1% PER; n = 39); 2) oral administration of trimethoprim/sulfamethoxazole (TMP/SMX; n = 36); and 3) a combination of 1% PER and TMP/SMX (n = 40). Follow-up visits were done 2 and 4 weeks later, and parents or caregivers of those who did not return were interviewed by telephone. If HLI was present at the 2-week follow-up, the child was retreated per their protocol. We defined successful treatment as the absence of adult lice and nymphal stage or eggs (nits). The presence of nits alone was not considered a treatment failure.. At the 2-week follow-up visit, successful treatment for groups 1, 2, and 3 was 79.5%, 83%, and 95%, respectively. At the 4-week follow-up, successful treatment was 72%, 78%, and 92.5% for groups 1, 2, and 3, respectively. The absolute risk reduction for recurrence comparing group 1 versus group 2 was 6%, group 2 versus group 3 was 14%, and group 1 versus group 3 was 20%. No major adverse complications were seen in any treatment group.. Our findings indicate that a combination of 1% PER and TMP/SMX is an effective alternative therapy for HLI. We recommend that the dual therapy with 1% PER and oral TMP/SMX be used and reserved in cases of multiple treatment failures or suspected cases of lice-related resistance to therapy.

Topics: Administration, Oral; Administration, Topical; Animals; Anti-Infective Agents; Child; Child, Preschool; Drug Therapy, Combination; Female; Humans; Insecticides; Lice Infestations; Male; Pediculus; Permethrin; Pyrethrins; Scalp Dermatoses; Trimethoprim, Sulfamethoxazole Drug Combination

Numerous therapies are available in both over-the-counter and prescription formulations for the treatment of head lice infestation. We summarize treatment recommendations from published literature and from a recent meta-analysis from the Cochrane Database of Systematic Reviews that describe the efficacy, safety, and resistance patterns of monotherapies available in the United States. If treatment with pyrethrin or permethrin fails to eradicate the infestation, the treatment of choice is malathion. However, because of malathion's flammability, it should be a second-line therapy. Orally administered ivermectin has been reported to be efficacious, but it is not currently a US Food and Drug Administration-approved pediculicide. Alternative therapies are also discussed, in addition to indications for prophylaxis, resistance reporting, and the social impact of infestation.

Topics: Animals; Hexachlorocyclohexane; Humans; Insecticides; Ivermectin; Lice Infestations; Malathion; Pediculus; Permethrin; Pyrethrins; Scalp Dermatoses; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Animals; Anti-Infective Agents; Drug Therapy, Combination; Humans; Insecticides; Lice Infestations; Pediculus; Permethrin; Trimethoprim, Sulfamethoxazole Drug Combination

Head lice remain a common problem worldwide. As resistance to available therapeutic agents can emerge rapidly, there is a need for continued research to find new and better agents. Until better agents are available, clinicians may find that rotational therapy, using different agents, may help to slow the emergence of resistance. Physical modalities, such as mechanical nit and louse removal and occlusive agents to asphyxiate the lice, should not be ignored, especially in light of our limited therapeutic armamentarium. All therapeutic agents are doomed to failure if infestation is allowed to recur. Classmates, playmates, and family members of infested children should be inspected for head lice. Efforts should be directed at fomite control and nit removal. Louse infestation must be addressed as a community-wide problem. Body lice remain important vectors of disease. War, natural disaster, and poverty favor the spread of body lice. As we work to solve these seemingly eternal problems, we must develop better agents to treat infestation and prevent the spread of body lice.

Topics: Adult; Animals; Carbaryl; Child; Diagnosis, Differential; Drug Combinations; Female; Hexachlorocyclohexane; Humans; Insecticides; Ivermectin; Lice Infestations; Malathion; Male; Pediculus; Permethrin; Petrolatum; Piperonyl Butoxide; Pyrethrins; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

No doubt, pediculosis capitis or Pediculus h. capitis infestation is an increasing health problem particularly among Egyptian children. Many chemical pediculocides are used with a variety of effectiveness and side effects. Meanwhile, Co-trimoxazole (Trimethoprim and sulphamethoxazole) have shown some pediculocidal action. In this paper, Co-trimoxazole was given to patients infested with pediculosis capitis. Prolonged course was needed to free the patients from adult and nymphal stages but not the eggs (nits). The results were discussed. It was concluded that until the discovery of cheap, safe and effective oral drug, topical application of pediculocides as ointment or shampoo is the method of choice.

Topics: Administration, Oral; Adult; Animals; Child; Humans; Lice Infestations; Pediculus; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Animals; Drug Combinations; Humans; Lice Infestations; Pediculus; Scalp; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Head lice commonly evoke feelings of disgust, revulsion, anger, and shame among parents and patients. There should, however, be no great cause for such alarm if a physician suspects pediculosis capitis. The recent introduction of several new pediculicidal drugs now allows a choice among four distinct therapeutic agents, which should substantially improve control of isolated cases and epidemics. Physicians must be aware that consumer groups are pressing public health authorities and drug manufacturers to establish proper treatment standards and safety warnings for the use of these agents. In addition, some controversy surrounds the use of lindane in children. This paper reviews the epidemiology and clinical appearance of pediculosis capitis in children, with emphasis on these recent developments. Pubic lice (Phthirus pubis) and body lice (Pediculus humanus corporis), both of which are much less common pediatric infestations, are mentioned only briefly.

Topics: Child; Drug Combinations; Eyelashes; Female; Fluorescein; Fluoresceins; Hexachlorocyclohexane; Humans; Lice Infestations; Malathion; Male; Petrolatum; Physostigmine; Pyrethrins; Random Allocation; Scalp; Sulfamethoxazole; Toluidines; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination