Leung Alexander K C, Lam Joseph M, Leong Kin Fon, Barankin Benjamin, Hon Kam Lun
Department of Pediatrics, The University of Calgary, Calgary, Alberta, Canada.
The Alberta Children's Hospital, Calgary, Alberta, Canada.
Drugs Context. 2022 Mar 14;11. doi: 10.7573/dic.2021-11-3. eCollection 2022.
Pediculosis capitis is a common human parasitic infestation in childhood. This article aims to provide a narrative updated review on the management of pediculosis capitis.
A PubMed search was performed with Clinical Queries using the key terms "pediculosis capitis" OR "head lice" OR "head louse". The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies and reviews published within the past 10 years. The search was restricted to articles published in English literature. The information retrieved from the search was used in the compilation of the present article.
Topical permethrin and pyrethrin formulated with piperonyl butoxide are the pediculicides of choice in areas where resistance to these products is low. When resistance to these products is suspected based on local levels of resistance or when treatment with these products fails despite their correct use, and reinfestation does not seem to be responsible, other topical treatment options include malathion, benzyl alcohol, dimethicone, spinosad and ivermectin. Wet combing should be considered for children younger than 2 years. Oral ivermectin and trimethoprim/sulfamethoxazole should be reserved for patients who do not respond to appropriate topical pediculicides.
Many topical pediculicides are effective for the treatment of pediculosis capitis. The use of some of these pediculicides is limited for safety reasons, especially in children younger than 2 years. Resistance to pediculicides, especially those with a neurotoxic mode of action, is another concern which may limit the use of some of these pediculicides. New products should be evaluated for effectiveness and safety. Wet combing is time-consuming and should not be used as the sole intervention in the general population.
头虱病是儿童常见的人体寄生虫感染。本文旨在对头虱病的管理提供一篇叙述性的最新综述。
使用关键词“头虱病”或“头虱”或“头虱成虫”通过临床查询在PubMed上进行检索。检索策略包括过去10年内发表的临床试验、荟萃分析、随机对照试验、观察性研究和综述。检索仅限于英文文献中发表的文章。从检索中获取的信息用于编写本文。
在对这些产品耐药性较低的地区，含增效醚的氯菊酯和除虫菊酯外用制剂是首选的灭虱剂。当根据当地耐药水平怀疑对这些产品耐药时，或在正确使用这些产品治疗失败且似乎不是再感染所致时，其他外用治疗选择包括马拉硫磷、苯甲醇、二甲硅油、多杀菌素和伊维菌素。2岁以下儿童应考虑湿发梳篦法。口服伊维菌素和甲氧苄啶/磺胺甲恶唑应保留给对适当的外用灭虱剂无反应的患者。
许多外用灭虱剂对头虱病有效。其中一些灭虱剂因安全原因使用受限，尤其是在2岁以下儿童中。对灭虱剂的耐药性，尤其是那些具有神经毒性作用方式的灭虱剂，是另一个可能限制其中一些灭虱剂使用的问题。应评估新产品的有效性和安全性。湿发梳篦法耗时且不应作为一般人群的唯一干预措施。
