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Karthikeyan K, Aishwarya M, Elayaperumal S. Effectiveness of topical 0.5% ivermectin shampoo in the treatment of pediculosis capitis among school-going female children. Int J Trichology 2022; 14:55-59. [PMID: 35531485 PMCID: PMC9069911 DOI: 10.4103/ijt.ijt_157_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 10/14/2021] [Indexed: 11/08/2022] Open
Abstract
Background: Pediculosis is a common ectoparasitic infestation in children. There are different treatment modalities that have been used in the treatment of pediculosis capitis from time immemorial, each with their own shortcomings. Increasing emergence of resistance to permethrin has led to the lookout for newer alternatives. Aims and Objectives: The role of topical ivermectin in the management of pediculosis in people with culturally different hair grooming practices is analyzed in this study. Materials and Methods: This observational open-label clinical study was conducted in September–November 2019 in the schools that were under the rural health center at South India among school-going female children aged between 13 and 16 years of age and diagnosed with pediculosis. Results: This study demonstrated that a single application of ivermectin shampoo was able to kill head lice in 86.2% of the participants. In participants with persistent infection (13.8%), a repeat application killed the entire louse and 100% efficacy was demonstrated. Topical ivermectin is devoid of systemic side effects of oral ivermectin. Topical ivermectin has found to be more effective than contemporary recommended agents such as malathion and permethrin.
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Stevenson B, Tesfaye W, Christenson J, Mathew C, Abrha S, Peterson G, Samarawickrema I, Thomas J. Comparative efficacy and safety of interventions for treating head lice: a protocol for systematic review and network meta-analysis. BMJ Paediatr Open 2021; 5:e001129. [PMID: 34041368 PMCID: PMC8112437 DOI: 10.1136/bmjpo-2021-001129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 04/22/2021] [Accepted: 04/24/2021] [Indexed: 11/07/2022] Open
Abstract
Background Head lice infestation is a major public health problem around the globe. Its treatment is challenging due to product failures resulting from rapidly emerging resistance to existing treatments, incorrect treatment applications and misdiagnosis. Various head lice treatments with different mechanism of action have been developed and explored over the years, with limited report on systematic assessments of their efficacy and safety. This work aims to present a robust evidence summarising the interventions used in head lice. Method This is a systematic review and network meta-analysis which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for network meta-analyses. Selected databases, including PubMed, Embase, MEDLINE, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials will be systematically searched for randomised controlled trials exploring head lice treatments. Searches will be limited to trials published in English from database inception till 2021. Grey literature will be identified through Open Grey, AHRQ, Grey Literature Report, Grey Matters, ClinicalTrials.gov, WHO International Clinical Trials Registry and International Standard Randomised Controlled Trials Number registry. Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two independent reviewers, with disagreements resolved via a third reviewer. The primary outcome measure is the relative risk of cure at 7 and 14 days postinitial treatment. Secondary outcome measures may include adverse drug events, ovicidal activity, treatment compliance and acceptability, and reinfestation. Information from direct and indirect evidence will be used to generate the effect sizes (relative risk) to compare the efficacy and safety of individual head lice treatments against a common comparator (placebo and/or permethrin). Risk of bias assessment will be undertaken by two independent reviewers using the Cochrane Risk of Bias tool and the certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations guideline for network meta-analysis. All quantitative analyses will be conducted using STATA V.16. Discussion The evidence generated from this systematic review and meta-analysis is intended for use in evidence-driven treatment of head lice infestations and will be instrumental in informing health professionals, public health practitioners and policy-makers. PROSPERO registration number CRD42017073375.
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Affiliation(s)
- Bill Stevenson
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Wubshet Tesfaye
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Julia Christenson
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Cynthia Mathew
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Solomon Abrha
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Gregory Peterson
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Pharmacy, University of Tasmania, Hobart, Tasmania, Australia
| | - Indira Samarawickrema
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Jackson Thomas
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
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Imboden A. Effective treatments for head lice. Nurse Pract 2019; 44:36-42. [PMID: 31436591 DOI: 10.1097/01.npr.0000574668.19239.db] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Head lice is a parasitic infestation common in children. Proper management is essential to treat lice in a safe, convenient, cost-effective, and efficacious manner. School lice policies are often antiquated and can stigmatize the child and family. Evidence-based care guidelines may significantly help families minimize the stress of lice.
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Affiliation(s)
- Annie Imboden
- Annie Imboden is a nursing instructor at Southern Illinois University, Edwardsville, Ill, and a Pediatric NP at Pediatric Group LLC, Carbondale, Ill
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New indications for topical ivermectin 1% cream: a case series study. Postepy Dermatol Alergol 2019; 36:58-62. [PMID: 30858780 PMCID: PMC6409879 DOI: 10.5114/ada.2019.82825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 11/23/2017] [Indexed: 11/17/2022] Open
Abstract
Introduction Topical ivermectin is an effective treatment for inflammatory papulopustular rosacea in adults. Positive therapeutic effects of ivermectin due to its potential anti-inflammatory properties could be achieved in the other facial dermatoses. Aim To assess the efficacy of topical ivermectin 1% cream therapy in mild and moderate perioral dermatitis (PD), seborrheic dermatitis (SD) and acne vulgaris (AV). Material and methods The study comprising 20 patients diagnosed with PD (8), SD (8) and AV (4) was conducted between November 2016 and July 2017. Two scales were applied to establish efficacy of the treatment: Investigator Global Assessment score (IGA) and Patient Global Assessment of Treatment (PGA). Results All patients responded to the treatment with topical ivermectin very well with a gradual reduction in inflammatory skin lesions. Complete or almost complete clearance (IGA score 0-1) was achieved in 20 cases. Four patients with PD achieved IGA 0-1 after 4 weeks of treatment, 1 patient after 5 weeks, 2 patients after 6 weeks and 1 patient after 12 weeks. In the total group of 8 patients with SD, 4 presented IGA 0 after 4 weeks of therapy, while 4 patients demonstrated IGA 1 after 6 weeks. Patients with AV required 8 and 10 weeks to obtain IGA 1. Nineteen patients of the studied group reported "very good" or "excellent" response to the therapy, only one patient with AV assessed therapy with topical ivermectin as "good". The adverse events were transient and manifested as mild-moderate desquamation, stinging and burning in 2 patients with PD. Conclusions Topical ivermectin was well tolerated and beneficial for treatment of mild and moderate PD, SD and AV.
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Cummings C, Finlay JC, MacDonald NE. Les infestations par les poux de tête : une mise à jour clinique. Paediatr Child Health 2018. [DOI: 10.1093/pch/pxx166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Carl Cummings
- Société canadienne de pédiatrie, comité de la pédiatrie communautaire, Ottawa (Ontario)
| | - Jane C Finlay
- Société canadienne de pédiatrie, comité de la pédiatrie communautaire, Ottawa (Ontario)
| | - Noni E MacDonald
- Société canadienne de pédiatrie, comité de la pédiatrie communautaire, Ottawa (Ontario)
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Cummings C, Finlay JC, MacDonald NE. Head lice infestations: A clinical update. Paediatr Child Health 2018; 23:e18-e24. [PMID: 29479286 DOI: 10.1093/pch/pxx165] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Head lice (Pediculus humanus capitis) infestations are not a primary health hazard or a vector for disease, but they are a societal problem with substantial costs. Diagnosis of head lice infestation requires the detection of a living louse. Although pyrethrins and permethrin remain first-line treatments in Canada, isopropyl myristate/ST-cyclomethicone solution and dimeticone can be considered as second-line therapies when there is evidence of treatment failure.
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Affiliation(s)
- Carl Cummings
- Canadian Paediatric Society, Community Paediatrics Committee, Ottawa, Ontario
| | - Jane C Finlay
- Canadian Paediatric Society, Community Paediatrics Committee, Ottawa, Ontario
| | - Noni E MacDonald
- Canadian Paediatric Society, Community Paediatrics Committee, Ottawa, Ontario
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Salavastru CM, Chosidow O, Janier M, Tiplica GS. European guideline for the management of pediculosis pubis. J Eur Acad Dermatol Venereol 2017; 31:1425-1428. [PMID: 28714128 DOI: 10.1111/jdv.14420] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/06/2017] [Indexed: 01/11/2023]
Abstract
Pediculosis pubis is caused by Phthirus pubis. The disease can be sexually transmitted. Patients main complain is of itch in the pubic area. The parasite can be spotted with the naked eye and blue macules can be observed in the pubic area. First line therapy consists of permethrin or pyrethrins with piperonyl butoxide. Second line therapy contains phenothrin, malathion and oral ivermectin. Partner management needs a look-back period of time of 3 months. Pubic lice incidence is increased in populations groups living in crowded spaces with scarce sanitary conditions as in time of war or disaster.
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Affiliation(s)
- C M Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - O Chosidow
- Department of Dermatology, Hôpital Henri Mondor AP-HP, Créteil, France
| | - M Janier
- STD Clinic, Dermatology Department, Hôpital Saint-Joseph, Paris, France
| | - G S Tiplica
- Department of Dermatology II, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Ullio-Gamboa G, Palma S, Benoit JP, Allemandi D, Picollo MI, Toloza AC. Ivermectin lipid-based nanocarriers as novel formulations against head lice. Parasitol Res 2017; 116:2111-2117. [DOI: 10.1007/s00436-017-5510-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 05/08/2017] [Indexed: 11/29/2022]
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Koch E, Clark JM, Cohen B, Meinking TL, Ryan WG, Stevenson A, Yetman R, Yoon KS. Management of Head Louse Infestations in the United States-A Literature Review. Pediatr Dermatol 2016; 33:466-72. [PMID: 27595869 DOI: 10.1111/pde.12982] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED Head lice are a source of scalp irritation, social disruption, and loss of school time. Health care providers need authoritative information to help avoid the costs and risks of ineffective treatment. A review was completed to provide relevant information on infestation treatments available in the United States. Three major biomedical databases were searched from 1985, when current products were first available, to 2014, focusing on U.S. REPORTS A total of 579 references remained after duplicates were removed. A search of the U.S. Food and Drug Administration website and labels of approved products were reviewed. A marked decline in the effectiveness of permethrin and synergized pyrethrins was found, probably because of resistance arising from widespread and indiscriminate use, and the emergence of knockdown resistance mutations. The potential toxicity of lindane in the setting of readily available, safer, and more effective alternatives, should limit its use. Prescription products shown to be safe and effective with a single application, without nit combing, are topical ivermectin, malathion, and spinosad, whereas benzyl alcohol requires two applications. Home remedies such as mayonnaise, and essential oils, have not been demonstrated to be safe or effective, and may carry potential for severe adverse events. The high risk of failure of over-the-counter treatments in eliminating head louse infestations drives a need for health care provider recognition of the limitations of current treatments and for judicious use of treatments that remain effective.
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Affiliation(s)
- Ellen Koch
- Division of Pediatric Dermatology, Johns Hopkins Medicine, Baltimore, Maryland
| | - John Marshall Clark
- Department of Veterinary and Animal Sciences, University of Massachusetts, Amherst, Massachusetts
| | - Bernard Cohen
- Division of Pediatric Dermatology, Johns Hopkins Medicine, Baltimore, Maryland
| | | | | | | | - Robert Yetman
- University of Texas-Houston Medical School, Houston, Texas
| | - Kyong Sup Yoon
- Department of Biological Sciences and Environmental Sciences Program, Southern Illinois University-Edwardsville, Edwardsville, Illinois
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Feldmeier H. Treatment of pediculosis capitis: a critical appraisal of the current literature. Am J Clin Dermatol 2014; 15:401-12. [PMID: 25223568 DOI: 10.1007/s40257-014-0094-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Pediculosis capitis is the most common ectoparasitic disease in children in industrialized countries and extremely common in resource-poor communities of the developing world. The extensive use of pediculicides with a neurotoxic mode of action has led to the development and spread of resistant head lice populations all over the world. This triggered the development of compounds with other modes of action. The current literature on treatment approaches of head lice infestation was searched, and published randomized controlled trials were critically analyzed. The following compounds/family of compounds were identified: spinosad, a novel compound with a new neurotoxic mode of action, isopropyl myristate, 1,2-octanediol, ivermectin, plant-based products, and dimeticones. The efficacy and safety of these compounds are reviewed and recommendations for the treatment of pediculosis capitis in individuals as well as the interruption of ongoing epidemics are provided.
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Affiliation(s)
- Hermann Feldmeier
- Institute of Microbiology and Hygiene, Charité University Medicine, Campus Benjamin Franklin, Hindenburgdamm 27, 12203, Berlin, Germany,
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Ahmad HM, Abdel-Azim ES, Abdel-Aziz RT. Assessment of topical versus oral ivermectin as a treatment for head lice. Dermatol Ther 2014; 27:307-10. [DOI: 10.1111/dth.12144] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Hesham M. Ahmad
- Department of Dermatology and Venereology, Faculty of Medicine; Minia University; Minia Egypt
| | - Eman S. Abdel-Azim
- Department of Dermatology and Venereology, Faculty of Medicine; Minia University; Minia Egypt
| | - Rasha T. Abdel-Aziz
- Department of Dermatology and Venereology, Faculty of Medicine; Minia University; Minia Egypt
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Deeks LS, Naunton M, Currie MJ, Bowden FJ. Topical Ivermectin 0.5% Lotion for Treatment of Head Lice. Ann Pharmacother 2013; 47:1161-7. [DOI: 10.1177/1060028013500645] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To investigate the pharmacology, pharmacokinetics, efficacy, adverse effects, and place in therapy of a single application of topical ivermectin 0.5% lotion for head lice treatment. Data Sources: Literature was obtained by searching MEDLINE, PubMed, CINAHL, and Scopus (January 1980 to January 2013). Abstracts were searched for the terms ivermectin AND (head lice or pediculus or pediculosis), topical ivermectin, ivermectin lotion, ivermectin AND (pharmacology OR pharmacokinetics). The New Drug Application filed with the Food and Drug Administration and the product data sheets for ivermectin were obtained. Study Selection and Data Extraction: All English-language articles retrieved from the search were evaluated for relevance to the objective. Data Synthesis: The recommended first-line head lice treatments in the United States are permethrin 1% or pyrethrins, with malathion 0.5% lotion used as a second-line treatment. Significantly more of the 289 head lice–infested participants using topical ivermectin 0.5% lotion were lice-free at day 15 when compared with vehicle control (73.8% vs 17.6%; P < .001) in 2 studies. Although this rate is lower than other third-line treatments (eg, spinosad 0.9% or benzyl alcohol 5%), topical ivermectin 0.5% lotion is well tolerated (pruritus, the most common adverse event, 0.9%) and requires only a single application. Conclusions: Topical ivermectin 0.5% lotion kills head lice by increasing chloride in muscle cells, causing hyperpolarization and paralysis. Only 1 application is required; when the treated eggs hatch, the lice are not viable because they cannot feed as a result of pharyngeal muscle paralysis. Minimal systemic absorption occurs following topical application. Studies have demonstrated that topical ivermectin 0.5% is a safe and efficacious treatment for head lice. Although it has no documented resistance, there is limited clinical experience, it requires a prescription, and it is expensive. Therefore it should be reserved as a third-line treatment for head lice in the United States.
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Affiliation(s)
- Louise S. Deeks
- University of Canberra, Canberra, Australia
- Canberra Hospital, Canberra, Australia
| | | | - Marian J. Currie
- Canberra Hospital, Canberra, Australia
- The Australian National University Medical School, Canberra, Australia
| | - Francis J. Bowden
- Canberra Hospital, Canberra, Australia
- The Australian National University Medical School, Canberra, Australia
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