Threadworms

Prescribing Notes:

• Antihelmintics should be used in combination with hygienic measures (hand washing, pants at night, morning shower) to break the cycle of auto-infection. On day 1 wash sleepwear and bed linen, dust and vacuum. All members of the family should be treated at the same time.
• Washing hands and scrubbing nails before each meal and after each visit to the toilet is essential. A bath taken immediately after rising will remove ova laid during the night.
• One dose of mebendazole is usually sufficient for treatment of threadworms; if infection persists a second dose may be repeated after 2 weeks.
• Mebendazole should not be used if <6 months of age. Use in age 6 months to 2 years is off label.
• Mebendazole is available over-the-counter.
• In pregnant women (at least in the first trimester) only use hygiene measures (for 6 weeks), mebendazole should not be used.
• For more information refer to the NICE CKS for threadworm.

Prescribing Notes:

• One dose of mebendazole is usually sufficient for treatment of threadworms.
• Hygiene measures are hand hygiene, wearing pants at night, morning shower including washing the perianal area PLUS wash sleepwear, bed linen, towels, cuddly toys, dust and vacuum on day one.
• In children less than 6 months old the treatment of infection is by hygiene measures alone for 6 weeks. In this age group during the day washing or wet-wiping the perianal area at 3 hourly intervals is required to remove the eggs.
• Mebendazole is available over-the-counter, the prescription only products and the over the counter products are licensed for different ages.
• All members of the family require treatment at the same time plus hygiene measures for 2 weeks (or 6 weeks if hygiene measures alone).
• Washing hands and scrubbing nails before each meal and after each visit to the toilet is essential. A bath taken immediately after rising will remove ova laid during the night.
• One dose of mebendazole is usually sufficient for treatment of threadworms; if infection persists a second dose may be repeated after 2 weeks.
• Mebendazole should not be used if < 6 months of age. Use in age 6 months to 2 years is off label.
• Mebendazole is available over-the-counter and via Pharmacy First.
• In pregnant women (at least in the first trimester) only use hygiene measures (for 6 weeks), mebendazole should not be used.
• For more information refer to the NICE CKS: Threadworm.

Prescribing Notes:

• Anthelmintics should be used in combination with hygiene measures (e.g. washing hands before eating, keeping nails short, washing around anal area) to break the cycle of auto-infection. All members of the family should be treated.
• One dose of mebendazole is usually sufficient for treatment of threadworms. If reinfection is suspected, a second dose can be given after 2 to 3 weeks.
• Mebendazole is not licensed for children under 2 years.
• During pregnancy, hygiene methods alone are preferred. Mebendazole is best avoided during pregnancy.
• Threadworm infection can be treated solely by meticulous attention to hygiene for 6 weeks. The worms in the intestine will die within this time, and, if no eggs are swallowed, no new worms will replace them.
• Hygiene measures can be found on the NHS website.

Examples of Counselling Points
Underwear should be worn in bed to prevent scratching.
Finger nails should be cut short.

When to advise patient to contact GP
Infection other than threadworm suspected.
Recent travel abroad.
Medication failure.
Pregnancy.
Children aged less than 2 years.