An observer-blinded study of 1% permethrin creme rinse with and without adjunctive combing in patients with head lice

Objectives: To determine if NIX (Warner Lambert Healthcare, Morris Plains, NJ) 1% Permethrin Creme Rinse Lice Treatment (1% PLT) without combing will effectively treat ≥95% of patients on day 2 or on day 15; to determine whether combing influences efficacy. Study design: A randomized, observer-blind...

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Published in:The Journal of pediatrics 2002-11, Vol.141 (5), p.665-670
Main Authors: Meinking, Terri L., Clineschmidt, Coleen M., Chen, Cong, Kolber, Michael A., Tipping, Robert W., Furtek, Christine I., Villar, Maria Elena, Guzzo, Cynthia A.
Format: Article
Language:English
Subjects:
Adolescent
Animals
Biological and medical sciences
Child
Child, Preschool
Dermatology
Female
Hair and nails disorders
Humans
Hygiene
Insecticides - administration & dosage
Lice Infestations - drug therapy
Lice Infestations - therapy
Male
Medical sciences
Pediculus
Permethrin - administration & dosage
Scalp Dermatoses - drug therapy
Single-Blind Method
Treatment Failure
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Summary:Objectives: To determine if NIX (Warner Lambert Healthcare, Morris Plains, NJ) 1% Permethrin Creme Rinse Lice Treatment (1% PLT) without combing will effectively treat ≥95% of patients on day 2 or on day 15; to determine whether combing influences efficacy. Study design: A randomized, observer-blinded study enrolled 95 infested adults and children. All patients were treated with 1% PLT on day 1 and, if still infested, on day 8. One third of households were randomized to the combing group and two thirds to the no-combing group. Efficacy was assessed by: (1) visual inspection on days 1, 2, 8, 9, and 15 and, (2) shampooing/straining on days 2, 9, and 15. The target efficacy was 95%. Results: In the no-combing group, the lice-free rate was 83.1% on day 2 (95% CI, 71.0-91.6), 45.8% on day 8 (before second treatment) (95% CI, 32.7-59.2), 77.6% on day 9 (95% CI, 64.7-87.5), and 78.3% on day 15 (95% CI, 65.8-87.9). Adjunctive combing did not improve efficacy on any day. Conclusions: In this population, 1% PLT was significantly less than 95% effective and suggests resistance to 1% PLT. The failure of nit removal combing by nonprofessional caregivers to improve efficacy demonstrates the unreliability of combing as adjunctive treatment in this setting. (J Pediatr 2002;141:665-70)
ISSN:0022-3476
1097-6833
DOI:10.1067/mpd.2002.129031