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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Villegas, Susan C. Breitzka, Robin L. |
| Description | Country affiliation: United States Author Affiliation: Villegas SC ( Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, New York, USA.) |
| Abstract | BACKGROUND: Head lice infestations are responsible for social and economic distress. Despite a reported increase in resistance, permethrin 1% is still the first-line treatment of head lice. Alternative topical pediculicidal agents include malathion and benzyl alcohol, but resistance is of growing concern. In 2011, a new pediculicide, spinosad, was introduced. OBJECTIVE: Our aim was to review the clinical pharmacology, efficacy, tolerability, and current place in therapy of spinosad for the treatment of head lice. METHODS: Pertinent articles and abstracts were identified through searches of MEDLINE/Ebsco and MEDLINE/Ovid from 1948 to September 2011 and International Pharmaceutical Abstracts from 1966 to September 2011. RESULTS: Two reports described 3 trials of spinosad used for the treatment of head lice. One study (n = 120) demonstrated efficacy of both spinosad 0.5% and spinosad 1% compared with placebo, with 82.5% and 86.1% of patients free of live lice 14 days after treatment, respectively, compared with 25.6% in the placebo group (P < 0.001 for each treatment). The difference between the spinosad 0.5% and 1% treatment groups was not significant. Two trials (n = 1038) comparing spinosad 0.9% with permethrin 1% reported greater efficacy for spinosad with absence of live lice 14 days after 1 or 2 treatments for 84.6% and 86.7%, respectively, of primary cases compared with 44.9% and 42.9% with permethrin (P < 0.001 for both studies). The most common reported adverse events were eye and scalp irritation, but they were not statistically significant (P = 0.329 and P = 0.395, respectively). Only application-site erythema reactions showed statistical significance, with 6.8% in the permethrin group versus 3.1% in the spinosad group (P = 0.007). CONCLUSIONS: Although limited, the available literature suggests that spinosad is an effective and well-tolerated agent for the treatment of head lice. In a time of increasing resistance, spinosad has demonstrated superior performance compared with permethrin. A review of the literature did not identify any studies comparing spinosad to benzyl alcohol 5% or malathion 0.5%. |
| File Format | HTM / HTML |
| ISSN | 01492918 |
| Issue Number | 1 |
| Volume Number | 34 |
| e-ISSN | 1879114X |
| Journal | Clinical Therapeutics |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2012-01-01 |
| Publisher Place | United States |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Pharmacology Insecticides Therapeutic Use Lice Infestations Drug Therapy Macrolides Pediculus Drug Effects Scalp Dermatoses Animals Drug Combinations Drug Costs Humans Administration & Dosage Adverse Effects Economics Pharmacokinetics Treatment Outcome Journal Article Review |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pharmacology Pharmacology (medical) |
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