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A highly efficacious pediculicide based on dimeticone: randomized observer blinded comparative trial.

Abstract

BACKGROUND

Infestation with the human head louse (Pediculus humanus capitis) occurs worldwide. Existing treatment options are limited, and reports of resistance to commonly used pediculicides have been increasing. In this trial we assessed the efficacy of a product containing a high (92%) concentration of the silicone oil dimeticone (identical in composition to NYDA(R)), as compared to a 1% permethrin lotion.

METHODS

Randomized, controlled, observer blinded clinical trial. Participants were recruited from a poor urban neighbourhood in Brazil where pediculosis capitis was highly prevalent. To minimize reinfestation during the trial, participants (145 children aged 5-15 years with head lice infestations) were transferred to a holiday resort outside the endemic area for a period of 9 days. Two applications of dimeticone or 1% permethrin were done, seven days apart. Outcome measures were defined as cure (absence of vital head lice) after first application and before and after second applications, degree of itching, cosmetic acceptability, and clinical pathology.

RESULTS

Overall cure rates were: day 2 - dimeticone 94.5% (95% CI: 86.6% - 98.5%) and permethrin 66.7% (95% CI: 54.6% - 77.3%; p < 0.0001); day 7 - dimeticone 64.4% (95% CI: 53.3% - 75.3%) and permethrin 59.7% (95% CI: 47.5% - 71.1%; p = 0.5); day 9 - dimeticone 97.2% (95% CI: 90.3% - 99.7%) and permethrin 67.6% (95% CI: 55.4%-78.2%); p < 0.0001). Itching was reduced similarly in both groups. Cosmetic acceptability was significantly better in the dimeticone group as compared to the permethrin group (p = 0.01). Two mild product-related incidents occurred in the dimeticone group.

CONCLUSION

The dimeticone product is a safe and highly efficacious pediculicide. Due to its physical mode of action (interruption of the lice's oxygen supply of the central nervous system), development of resistance is unlikely.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN15117709.

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  • Authors+Show Affiliations

    ,

    Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil. heukelbach@web.de

    , , , ,

    Source

    MeSH

    Adolescent
    Animals
    Brazil
    Child
    Child, Preschool
    Dimethylpolysiloxanes
    Female
    Humans
    Insecticides
    Lice Infestations
    Male
    Pediculus
    Permethrin
    Scalp Dermatoses
    Treatment Outcome

    Pub Type(s)

    Comparative Study
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18783606

    Citation

    TY - JOUR T1 - A highly efficacious pediculicide based on dimeticone: randomized observer blinded comparative trial. AU - Heukelbach,Jorg, AU - Pilger,Daniel, AU - Oliveira,Fabíola A, AU - Khakban,Adak, AU - Ariza,Liana, AU - Feldmeier,Hermann, Y1 - 2008/09/10/ PY - 2008/4/13/received PY - 2008/9/10/accepted PY - 2008/9/10/aheadofprint PY - 2008/9/12/pubmed PY - 2008/10/24/medline PY - 2008/9/12/entrez SP - 115 EP - 115 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 8 N2 - BACKGROUND: Infestation with the human head louse (Pediculus humanus capitis) occurs worldwide. Existing treatment options are limited, and reports of resistance to commonly used pediculicides have been increasing. In this trial we assessed the efficacy of a product containing a high (92%) concentration of the silicone oil dimeticone (identical in composition to NYDA(R)), as compared to a 1% permethrin lotion. METHODS: Randomized, controlled, observer blinded clinical trial. Participants were recruited from a poor urban neighbourhood in Brazil where pediculosis capitis was highly prevalent. To minimize reinfestation during the trial, participants (145 children aged 5-15 years with head lice infestations) were transferred to a holiday resort outside the endemic area for a period of 9 days. Two applications of dimeticone or 1% permethrin were done, seven days apart. Outcome measures were defined as cure (absence of vital head lice) after first application and before and after second applications, degree of itching, cosmetic acceptability, and clinical pathology. RESULTS: Overall cure rates were: day 2 - dimeticone 94.5% (95% CI: 86.6% - 98.5%) and permethrin 66.7% (95% CI: 54.6% - 77.3%; p < 0.0001); day 7 - dimeticone 64.4% (95% CI: 53.3% - 75.3%) and permethrin 59.7% (95% CI: 47.5% - 71.1%; p = 0.5); day 9 - dimeticone 97.2% (95% CI: 90.3% - 99.7%) and permethrin 67.6% (95% CI: 55.4%-78.2%); p < 0.0001). Itching was reduced similarly in both groups. Cosmetic acceptability was significantly better in the dimeticone group as compared to the permethrin group (p = 0.01). Two mild product-related incidents occurred in the dimeticone group. CONCLUSION: The dimeticone product is a safe and highly efficacious pediculicide. Due to its physical mode of action (interruption of the lice's oxygen supply of the central nervous system), development of resistance is unlikely. TRIAL REGISTRATION: Current Controlled Trials ISRCTN15117709. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/18783606/A_highly_efficacious_pediculicide_based_on_dimeticone:_randomized_observer_blinded_comparative_trial_ L2 - http://www.biomedcentral.com/1471-2334/8/115 ER -