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Comparative In Vitro Pediculicidal Efficacy of Treatments in a Resistant Head Lice Population in the United States
Terri L. Meinking, BA;
Lidia Serrano;
Bruce Hard, MA;
Pamela Entzel, JD, MPH;
Glendene Lemard, MA;
Elisabeth Rivera;
Maria Elena Villar, MPH
Arch Dermatol. 2002;138:220-224.
Objective To compare the pediculicidal activity of 5 head lice products available
in the United States on head lice from south Florida.
Design In vitro pediculicidal product comparison.
Setting Lice Source Services, Inc, located in Plantation, Fla, a clinic for
the treatment and grooming of individuals with pediculosis capitis.
Participants Head lice were collected from healthy clients with Pediculus capitis that came to Lice Source Services, Inc, to seek their
services.
Interventions Within 2 to 6 hours of capture, lice were placed in continuous direct
contact with the pediculicide products and observed at regular intervals.
Results were compared with findings of a recent study of a treatment-sensitive
population of head lice conducted in Panama.
Main Outcome Measure Percentage of lice dead at regular observation intervals between 5 minutes
and 3 hours of continuous exposure to the pediculicides.
Results Two prescription products, Ovide lotion (0.5% malathion) and 1% lindane
shampoo, were ranked in the same order as in 2 previous studies (first and
last, respectively). The order of effectiveness from most to least effective
was as follows: Ovide lotion, A-200 shampoo (a natural pyrethrin product synergized
with piperonyl butoxide), undiluted Nix (1% permethrin), diluted Nix, RID
(a natural pyrethrin product synergized with piperonyl butoxide), and 1% lindane
shampoo.
Conclusions There were statistically significant differences in the efficacy of
all the products when compared with the results found in the recent study
in Panama, except for Ovide lotion. Of those tested, Ovide was the only pediculicide
in the United States that had not become less effective. The difference in
efficacy of 1% lindane, Nix, and pyrethrins between the Panama and Florida
studies supports the argument that some head lice in the United States have
become resistant to these treatments.
From the Field Epidemiology Survey Team (FEST), Department of Dermatology
and Cutaneous Surgery, University of Miami School of Medicine, Miami, Fla
(Mss Meinking, Entzel, Lemard, and Villar); Lice Source Services, Inc, Plantation,
Fla (Mss Serrano and Rivera and Mr Hard); and University of Miami, School
of International Studies, Miami (Ms Lemard).
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