trimethoprim--sulfamethoxazole-drug-combination and Scalp-Dermatoses

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

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

Melioidosis is an emerging infection in the tropics caused by the bacterium Burkholderia pseudomallei. Poorly controlled diabetes is a known risk factor. Melioidosis has a broad spectrum of clinical manifestations ranging from a localized abscess to pneumonia to disseminated sepsis with multiorgan failure. Pyrexia of unknown origin is a common presentation. Abscesses in unusual anatomical locations are well known to be associated with melioidosis.. We report a case of a 64-year-old Sri Lankan Sinhalese man with prolonged fever and constitutional symptoms with a neglected swelling over the back of the scalp who was found to have an abscess in the subgaleal space of the scalp during surgical drainage. Burkholderia pseudomallei was isolated in pus culture, and melioidosis serology was highly positive. The patient was treated with ceftazidime for 2 weeks, followed by co-trimoxazole for another 3 months. He made a complete clinical recovery with normalization of inflammatory markers. To the best of our knowledge, this is the first case of subgaleal abscess following melioidosis infection reported in the literature.. Abscesses in anatomically unusual locations should raise suspicion for melioidosis infection, particularly among patients with risk factors such as diabetes mellitus.

Topics: Abscess; Burkholderia pseudomallei; Ceftazidime; Humans; Male; Melioidosis; Middle Aged; Scalp Dermatoses; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Mycetoma is chronic inflammatory process characterized by areas of tumefaction with draining sinus tracts. It affects the foot in 80% of cases. The purpose of this report is to describe a case that posed a diagnostic challenge due to unusual scalp location and clinical presentation.. A 23-year-old woman residing in a rural zone of Senegal consulted for indolent lesions ongoing on the scalp for 2 years. Physical examination showed two soft tumid lesions measuring about 3 cm in diameter on the vertex. The surface of the lesions was crusty but showed no sign of granules. Skull x-ray was normal. Skin biopsy demonstrated a polymorphous granulomatous infiltrate with foci of suppuration circumscribing small, irregular grains with radiating filaments. Mycological culture on Lowenstein medium demonstrated Actinomadurella pelletiere. Treatment with cotrimoxazole for 8 months led to significant regression of the lesions.. The mycetoma described in this report posed a diagnostic challenge because of its unusual scalp location and especially its tumoral or pseudo-cystic presentation. This clinical form of mycetoma must be taken into account for diagnosis in any patient from endemic areas.

Topics: Actinomycetales; Actinomycetales Infections; Adult; Anti-Infective Agents; Female; Humans; Mycetoma; Scalp Dermatoses; Time Factors; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Actinomycetoma is the most frequent type of mycetoma in Mexico. Localization on the scalp is very rare. Because of this topography and potential spread to the brain, the present case became a diagnostic and therapeutic challenge.. We report the case of a 44-year-old woman with a 6 × 5 cm red, friable, granulomatous, vascular neoformation on the scalp and eye diagnosed as Nocardia brasiliensis actinomycetoma.. A combination of amikacin and oral trimethoprim-sulfamethoxazole (SXT) was successfully administered with an excellent outcome and no side effects.. This is a rare presentation of mycetoma of the scalp that was cured in 12 weeks with a combination of amikacin and SXT.

Topics: Accidents, Traffic; Adult; Anti-Infective Agents; Eye Infections, Bacterial; Female; Humans; Mexico; Mycetoma; Nocardia Infections; Scalp Dermatoses; Trimethoprim, Sulfamethoxazole Drug Combination

A young man presented with a large multilobulated and mutilating tumour of the scalp, which had been relapsing for years. Histological examination of a biopsy from the lesion revealed chronic inflammation with granulation tissue and presence of granules with eosinophilic periphery, which was positive for Gram, Grocott and periodic-acid-Schiff stains. A large excision was performed. Cultures grew Staphylococcus aureus. The patient was treated with penicillin G, but 4 weeks after the start of treatment, new small nodules appeared over the same area. All these new nodules disappeared within 2 weeks the addition of clindamycin and cotrimoxazole. This triple antibiotic treatment was carried on for 18 months, and the patient remained disease-free after a follow-up of 4 years. Although the lesions were clinically and histologically suggestive of actinomycosis, culture revealed that they were caused by a completely different organism. We suggest grouping such lesions under a single term "granular bacteriosis" and combining surgery with broad-spectrum antibiotics covering Actinomyces species and botryomycosis-causing organisms (mainly Staphylococcus).

Topics: Adolescent; Anti-Bacterial Agents; Clindamycin; Diagnosis, Differential; Humans; Male; Recurrence; Scalp Dermatoses; Staphylococcal Skin Infections; Staphylococcus aureus; Treatment Outcome; 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

Botryomycosis is a rare and chronic but readily treatable form of mycetoma. It is caused by a persistent bacterial infection and is distinguished by the formation of grains and multiple sinuses in the skin. The most usual cause is caused by Staphylococcus aureus. The authors' experience with four Transvaal cases is reported. In one case there was destruction of the skull and penetration of the cranial cavity by the botryomycotic process. Treatment with a range of common antistaphylococcal antibiotics led to astonishingly rapid recovery. Among the drugs used, cotrimoxazole was, perhaps, the most practical.

Topics: Adult; Africa; Aged; Chronic Disease; Humans; Male; Mycetoma; Scalp Dermatoses; Staphylococcus aureus; Trimethoprim, Sulfamethoxazole Drug Combination