Diaz James H
School of Public Health and Medicine, Louisiana State University Health Sciences Center, New Orleans, USA.
J La State Med Soc. 2008 Jul-Aug;160(4):210-2, 214-20.
Head louse and scabies mite infestations are common among pre-school and school-age children, and topical pesticides are frequently prescribed to treat such conditions. Ectoparasite resistance to the safest and most commonly prescribed pyrethrin/pyrethroid pesticides for ectoparasitic infections has, however, been increasing since the 1980s. The increasing resistance of these arthropods to the safest pesticides may lead to greater use of more toxic, alternative pesticides to control infestations and to prevent institutional outbreaks. MEDLINE and Cochrane searches, 1966-2008, were conducted to assess the impact of increasing pesticide resistance on prescribing practices for ectoparasitic infections and to describe the evolving global epidemiology of pediatric poisonings by more toxic pediculicides and miticides, including carbamates, organochlorines, and organophosphates. Pharmacists, physicians, and poison control personnel should be fully informed about increasing pesticide resistance among the most commonly encountered ectoparasites of children and the institutionalized and be prepared to prevent and to treat accidental home and institutional pesticide poisonings with more toxic pesticides.
头虱和疥疮螨感染在学龄前和学龄儿童中很常见，局部用杀虫剂经常被用于治疗此类病症。然而，自20世纪80年代以来，外寄生虫对用于治疗外寄生虫感染的最安全、最常用的除虫菊酯/拟除虫菊酯类杀虫剂的抗药性一直在增加。这些节肢动物对最安全的杀虫剂的抗药性不断增强，可能会导致更多地使用毒性更大的替代杀虫剂来控制感染并防止机构内爆发疫情。我们检索了1966年至2008年的医学在线数据库（MEDLINE）和考克兰系统评价数据库（Cochrane），以评估杀虫剂抗药性增加对治疗外寄生虫感染的处方行为的影响，并描述毒性更大的杀虱剂和杀螨剂（包括氨基甲酸盐类、有机氯类和有机磷类）导致的小儿中毒在全球范围内不断变化的流行病学情况。药剂师、医生和中毒控制人员应充分了解儿童及机构中最常见的外寄生虫对杀虫剂的抗药性不断增加的情况，并准备好预防和治疗因毒性更大的杀虫剂导致的家庭意外中毒和机构内中毒事件。
