Arthropod and parasitic antibiotics

Antibiotics by diagnosis

• Bone and joint antibiotics
• Cardiovascular antibiotics
• ENT antibiotics
• Eye antibiotics
• GI antibiotics
• GU antibiotics
• Neuro antibiotics
• OB/GYN antibiotics
• Pulmonary antibiotics
• Skin and soft tissue antibiotics
• Bioterrorism antibiotics
• Environmental exposure antibiotics
• Immunocompromised antibiotics
• Post exposure prophylaxis antibiotics
• Pediatric antibiotics
• Sepsis antibiotics
• Arthropod and parasitic antibiotics

For antibiotics by organism see Microbiology (Main)

Lice

Over the Counter (OTC)

• Permethrin 1% lotion shampoo apply 10 min rinse repeat day 9 (if >2 months old)
  • Wash hair with non-conditioned shampoo
  • Apply Permethrin for 10 min and rinse
  • Repeat on day 9
• Pyrethrin lotion
  • Apply to affected areas and wash off after 10 min
  • Repeat in 7 days
• Dimethicone therapy
  • First, apply the product to dry hair, then wait 10 min. Next, with product still in the hair, separate hair into small sections and comb hair to remove lice and eggs. Use a lice comb to remove lice and their eggs from hair. Finally, shampoo hair thoroughly with regular shampoo and warm water. Repeat as needed.

Prescription

Reserved for failed OTC treatment

• Spinosad 0.9% topical suspension (if >6 months old)
  • Apply to scalp and air and wash off after 10 min.
  • Repeat in 10 days
• Malathion 0.5% lotion (if >6 years old)
  • Applied to affected areas and wash after 8 hrs
  • Repeat in 7 days
• Benzyl Alcohol 5% lotion (> 6 months old)
  • Apply to dry hair and wash off after 10 min
  • Repeat in 7 days
• Ivermectin 400mcg/kg PO day 1 then repeat day 7
  • Once on day 1 THEN once in 7 days
  • Reserved for patients failing topical treatment
• Lindane therapy
  • Only consider if patient has failed two prior prescription treatments
  • Avoid in children <50 kg due to seizure association

Eyelash Infestation

• Apply ophthalmic petroleum jelly q12hrs x 10 days

Pediatrics <2yo

• Wet combing is an alternative to medical therapy

Pinworms

Treatment targeted against Enterobius vermicularis; All family members should be treated at the same time

Adult

• Mebendazole 100mg PO once then repeat in 2 weeks OR
  • Okay during breastfeeding
• Albendazole 400mg PO once then repeat in 2 weeks OR
• Pyrantel Pamoate 11mg/kg (max 1g) PO once then repeat in 2 weeks
  • First choice for pregnant patients
    • Treat in pregnancy only if the infection is compromising the pregnancy (i.e. weight loss, sleeplessness); withhold until the 3rd trimester if possible.

Pediatric

• 2 years or older:
  • Mebendazole 100mg PO once then repeat in 2 weeks OR
  • Albendazole 400mg PO once then repeat in 2 weeks OR
• <2 years
  • Albendazole 200mg PO once then repeat in 2 weeks

Scabies

Adults

• Permethrin 5% cream neck down leave 8-12hrs repeat 1-2wks for all family members
  • Apply from neck down
  • Leave on for 8-12hr before washing off
  • Has 95-98% success rate, may reapply in 1-2wks if incomplete effect
• Ivermectin 200mcg/kg PO repeat in 2wks
  • Also viable option in adolescent or adult with insecure social situation
  • Success rate 70%, increases if give repeat dose 2wks after
  • Contraindicated in lactating women and children < 15kg

Pediatric

• Permethrin 5% cream, apply head to toe (avoid mucous membranes), leave 8-12hrs, wash off; repeat in 1-2 weeks
  • FDA approved for >2 months of age; also recommended for neonatal scabies
• Ivermectin 200mcg/kg PO, repeat in 2 weeks; only for children >15kg