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Recurrent Pinworm Infestation Despite Taking Pyrantel Embonate. Any Other Treatment?

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Posted on Fri, 13 Jul 2012
Question: Hi, I've recently somehow caught pinworms and they won't go away. I've probably had them for 3 weeks, but when I think about it, I've had itching for a long time - could well be a few years! It's only the past few weeks that they have been really bad and I've been trying to treat them.

I'm getting so depressed because I've done everything. I've started by taking Pyrantel Embonate and it would get better for a day or two, and then they would come back. I think starting taking Mebendazole and instead of taking the 1 pill for threadworms that it mentioned, i decided to do the whole course - 1 pill in the morning, and 1 at night for 3 consecutive days. It got better by the second day and I thought I was in the clear, took them this morning and tonight (3rd day) and they're back!

I've even been taking herbal remedies like eating lots and lots of garlic, pumpkin seeds, and even eating lots of pineapple and drinking pineapple juice.

I think that I must be reinfecting myself? I'm here because I don't know what else to do. I'm so depressed because of it. I live at university in a room by myself which I why I think I might be reinfecting myself.

I'm actually leaving tomorrow and going home (interstate) because I've finished studies for the semester. I'm scared that when I come back I'll reinfect myself? How long do the eggs last for and what can I do? I've been washing everything daily and changing underwear at least 2 times a day.

You really are my last hope. I've been to doctors and they keep saying to take the de-worm medication. It's not working.

Please ask me questions and I'll answer them for you. I really need your help.

Thank you, XXXXXXX
doctor
Answered by Dr. Aparna Kohli (18 minutes later)
Hi XXXXXXX
Thanks for writing in.
I do understand your situation.
You're right about reinfecting yourself. The pinworm eggs generally become infective 2-3 hours after getting deposited on the skin of the anus. They can survive upto 2-3 weeks on clothing and bedding.
As far as the treatment is concerned, re-infection is very common and we usually prescribe ivermectin in combination with mebendazole . If mebendazole is used alone, the dose is repeated every 3 weeks for a total of 3 times. I would suggest you speak with your general physician about this as these are prescription drugs.
About preventing re-infection, the following measures would help:
a. Washing your hands is the single most important step you can take. For a guide on when and how to wash your hands, have a look at this link WWW.WWWW.WW b. Clean the anal opening after each bowel movement with soap and water. Make sure you use clean washcloths or paper towels each time.
c. Your toilet seat needs to scrubbed with disinfectant daily
d. Your bed linen, towels and clothes need to be washed in hot boiling water with detergent.
e. Vacuum carpets and floors well.
f. Scrub washable areas. Vacuum or brush upholstered furniture. Change the vacuum
cleaner bag daily and seal it before throwing it away.

I am sure these measures would help you prevent re-infection.
I hope this addresses your concerns. I will be happy to address any more concerns that you might have.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aparna Kohli (1 hour later)
The issue I guess is that I've done all that and I still can't seem to get rid of them. I see online that some people live with them for up to 30 years and I don't want that and im getting scared now. I don't know what else to do. Thank you for your time to answer my question though. I really appreciate it. Just not sure what else to do because I've done everything you mentioned unfortunately.
doctor
Answered by Dr. Aparna Kohli (3 hours later)
Hi XXXXXXX
Thanks for writing back.
I dont think you would need to suffer for such a long period. I am sure I can help.
a. I think you need to look at whether you really are doing all of these simultaneously and diligently. Also, clipping your nails and refraining from scratching the areas are 2 more issues that need to be addressed.
b. Do speak with your general physician about a course of albendazole or ivermectin. These are 2nd line drugs and are used in some cases.
Do let me know if this helps.
Regards
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Aparna Kohli

General & Family Physician

Practicing since :2009

Answered : 983 Questions

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Recurrent Pinworm Infestation Despite Taking Pyrantel Embonate. Any Other Treatment?

Hi XXXXXXX
Thanks for writing in.
I do understand your situation.
You're right about reinfecting yourself. The pinworm eggs generally become infective 2-3 hours after getting deposited on the skin of the anus. They can survive upto 2-3 weeks on clothing and bedding.
As far as the treatment is concerned, re-infection is very common and we usually prescribe ivermectin in combination with mebendazole . If mebendazole is used alone, the dose is repeated every 3 weeks for a total of 3 times. I would suggest you speak with your general physician about this as these are prescription drugs.
About preventing re-infection, the following measures would help:
a. Washing your hands is the single most important step you can take. For a guide on when and how to wash your hands, have a look at this link WWW.WWWW.WW b. Clean the anal opening after each bowel movement with soap and water. Make sure you use clean washcloths or paper towels each time.
c. Your toilet seat needs to scrubbed with disinfectant daily
d. Your bed linen, towels and clothes need to be washed in hot boiling water with detergent.
e. Vacuum carpets and floors well.
f. Scrub washable areas. Vacuum or brush upholstered furniture. Change the vacuum
cleaner bag daily and seal it before throwing it away.

I am sure these measures would help you prevent re-infection.
I hope this addresses your concerns. I will be happy to address any more concerns that you might have.
Regards