An observer-blinded study of 1% permethrin creme rinse with and without adjunctive combing in patients with head lice

Terri L. Meinking, Coleen M. Clineschmidt, Cong Chen, Michael A Kolber, Robert W. Tipping, Christine I. Furtek, Maria Elena Villar, Cynthia A. Guzzo

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55 Scopus citations

Abstract

Objectives: To determine if NIX (Warner Lambert Healthcare, Morris Plains, NJ) 1% Permethrin Creme Rinse Lice Treatment (1% PLT) without combing will effectively treat ≥95% of patients on day 2 or on day 15; to determine whether combing influences efficacy. Study design: A randomized, observer-blinded study enrolled 95 infested adults and children. All patients were treated with 1% PLT on day 1 and, if still infested, on day 8. One third of households were randomized to the combing group and two thirds to the no-combing group. Efficacy was assessed by: (1) visual inspection on days 1, 2, 8, 9, and 15 and, (2) shampooing/straining on days 2, 9, and 15. The target efficacy was 95%. Results: In the no-combing group, the lice-free rate was 83.1% on day 2 (95% CI, 71.0-91.6), 45.8% on day 8 (before second treatment) (95% CI, 32.7-59.2), 77.6% on day 9 (95% CI, 64.7-87.5), and 78.3% on day 15 (95% CI, 65.8-87.9). Adjunctive combing did not improve efficacy on any day. Conclusions: In this population, 1% PLT was significantly less than 95% effective and suggests resistance to 1% PLT. The failure of nit removal combing by nonprofessional caregivers to improve efficacy demonstrates the unreliability of combing as adjunctive treatment in this setting.

Original languageEnglish
Pages (from-to)665-670
Number of pages6
JournalJournal of Pediatrics
Volume141
Issue number5
DOIs
StatePublished - Nov 1 2002

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Meinking, T. L., Clineschmidt, C. M., Chen, C., Kolber, M. A., Tipping, R. W., Furtek, C. I., Villar, M. E., & Guzzo, C. A. (2002). An observer-blinded study of 1% permethrin creme rinse with and without adjunctive combing in patients with head lice. Journal of Pediatrics, 141(5), 665-670. https://doi.org/10.1067/mpd.2002.129031