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.