For children over 6 months of age, the recommended first-line treatment for Enterobius vermicularis (threadworm) infection is a single dose of an anthelmintic such as mebendazole NICE CKS. If the infection persists, the dose may need to be repeated after 2 weeks NICE CKS.
For children under the age of 6 months, treatment should consist of hygiene measures alone for 6 weeks NICE CKS. Mebendazole is not licensed for use in children under 2 years of age NICE CKS. For children under 2 years, it is recommended to consult with an infectious disease specialist before administering anthelmintics, as these drugs have not been extensively studied in this age group NICE CKS.
It is also recommended to consider treating all household contacts, unless contraindicated, due to the high transmissibility of threadworms NICE CKS.
Rigorous hygiene measures are crucial alongside medication or as the sole treatment. These measures should be followed for 2 weeks if treated with mebendazole, or for 6 weeks if using hygiene measures alone NICE CKS. Key hygiene practices include: thorough hand washing with soap and warm water after using the toilet, changing nappies, and before handling food; regular nail cutting and avoiding nail biting or scratching around the anus; showering each morning, including the perianal area, to remove eggs; and changing bed linen and nightwear daily for several days after treatment, washing them on a hot cycle NICE CKS. Thorough dusting and vacuuming (including mattresses) and damp-dusting bathroom surfaces are also advised NICE CKS.
Key References
- CKS - Threadworm
- CKS - Roundworm
- CKS - Gastroenteritis
- CG99 - Constipation in children and young people: diagnosis and management
- CG84 - Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management
- CG57 - Atopic eczema in under 12s: diagnosis and management
- CG111 - Bedwetting in under 19s