Oral Ivermectin versus Malathion Lotion for Difficult-to-Treat Head Lice

Abstract

For difficult-to-treat head-lice infestation, oral ivermectin, given twice at a 7-day interval, had superior efficacy as compared with topical 0.5% malathion lotion, a finding that suggests that it could be an alternative treatment. (ClinicalTrials.gov number, NCT00819520.)

Permethrin and malathion resistance in head lice: Results of ex vivo and molecular assays

“…Recently, oral ivermectin has been shown to be a therapeutic option for difficult-to-treat head lice. 31 Ex vivo assays showed complete efficacy of malathion in our series after 1 hour of exposure. At shorter exposure times, the efficacy was not total but appeared higher than with the permethrin plus PB formulation.…”

“…Malathion appeared to have retained its efficacy in France, as shown by a recent controlled trial comparing oral ivermectin to 0.5% malathion lotion in four countries including France. 31 Given these results, it seems that formulations containing malathion can still be recommended as pediculicides for schoolchildren of Paris. The absence of malathion resistant head lice in Paris is not sufficient to draw any conclusion for other populations (for instance in other French cities).…”

Head Lice

“…52,53 Most recently, a single oral dose of 400 g/kg repeated in 7 days has been shown to be more effective than 0.5% malathion lotion. 54 Ivermectin may cross the blood/brain barrier and block essential neural transmission; young children may be at higher risk of this adverse drug reaction. Therefore, ivermectin should not be used for children who weigh less than 15 kg.…”

Le prix Nobel de Médecine 2015 au service des pays tropicaux

“…Elle est systématiquement prescrite, en région tropicale, chez les sujets immunodéprimés pour éviter la diffusion à tout l'organisme de larves responsables d'une anguillulose maligne éventuellement mortelle [28]. L'ivermectine devient le médicament quasi incontournable dans le traitement des larva migrans cutanées [29], des gales à sarcoptes, en privilégiant l'administration de 2 doses à 10 jours d'intervalle [30,31] et, plus récemment, des poux [32].…”