What can a nurse do to help confirm a suspected diagnosis of intestinal infestation with pinworms?

208.A nurse can assist in confirming a suspecteddiagnosis of intestinal infestation withpinworms in a 6 year old child bya.Asking the mother to collect stools for 3consecutive days for cultureb.Instructing the mother to do an anal scotchtape test early in the morningc.Having the mother bring in the child’s stoolsfor visual examination for 3 daysd.Assisting the mother to schedule ahypersensitivity test of the child’s bloodserum

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Page 2

Treatment of enterobiasis

Approved active substances (references)Clinical pictureDoseRepeat treatmentSuccess rate (%)Side effects, interactionsComments
Mebendazole

(4, e11– e13)

Initial infection100–200 mg (single dose), approved from 2 years of ageAfter 14 and 28 days90–100Generally well tolerated; occasional abdominal symptoms (nausea, vomiting, diarrhea, flatulence, cramps); vigilance required for interactions with metronidazole, cimetidine, praziquantel, and dexamethasoneTreatment of first choice in children >2 years and adults without extraintestinal infection; ovicidal; drug of first choice (off-label) during pregnancy and lactation with careful benefit–risk assessment and careful monitoring required
Chronic recurrent courseEvery 14 days for a period of 16 weeksNo dataMedication to be extended to all household members and sexual partners
Pyrantel embonate

(4, e11– e13)

Initial infection10 mg/kg body weight (BW) (single dose), approved from 7 months of ageAfter 14 and 28 days90–100Maximum dose 1 g; generally well tolerated, occasional loss of appetite, insomnia, headache, dizziness, nausea, vomiting, diarrhea; transaminase elevation common; contraindicated in liver damage; interacts with piperazine and theophyllineRestrictions on use: infants <6 months; dosed according to body weight
Pyrvinium embonate

(4, e11– e13)

Initial infection5 mg/kg BW (single dose), approved from the age of 4 monthAfter 14 and 28 daysNo dataMaximum dose 400 mg; generally well-tolerated; occasional abdominal symptoms; possible reddening of stool; contraindicated in liver damage, kidney failure and chronic inflammatory bowel diseaseRestriction on use: infants <3 months; dosed according to body weight
Other active substances (references)Clinical pictureDoseRepeat treatmentSuccess rate (%)Side effects, interactionsComments
Albendazole

(4, 14, e11– e13)

Initial infection200–400 mg (single dose), children >2 years and weighing more than 10 kg receive 400 mg, children aged 1 year and weighing less than 10 kg receive 200 mgAfter 14 and 28 days90–100Generally well-tolerated, occasional abdominal symptoms; potentially teratogenic and hepatotoxic; interacts with metronidazole, cimetidine, praziquantel, and dexamethasoneGenerally only used for extraintestinal (urogenital) infection or recurrence (off-label); ovicidal; not suitable for children <6 years; less safety data than for mebendazole; cost-intensive, only available in 60-tablet pack in germany; approved for enterobiasis treatment in switzerland
Chronic recurrent courseEvery 14 days for a period of 16 weeksNo dataMedication to be extended to all household members and sexual partners
Extraintestinal infection (urogenital)After 14 and 28 daysSuperior to mebendazole in extraintestinal infection due to systemic effect
Ivermectin

(e18, e19)

Extraintestinal infection (urogenital)200 µg/kg BW (single dose)After 14 and 28 days53–85Transient hypereosinophilia, transamine elevationGenerally only used in exceptional cases for extraintestinal (urogenital) infection (off-label); no safety guidelines for children <15 kg bw