Pyrethrins with Piperonyl Butoxide
Class: Scabicides and Pediculicides
ATC Class: P03BA
VA Class: AP300
CAS Number: 8003-34-7
Brands: A200, Licide, Pronto, RID
Introduction
Pediculicide; fixed-combination preparation containing pyrethrins (a pediculicide) and piperonyl butoxide (has little or no insecticidal activity but potentiates that of pyrethrins).
Uses for Pyrethrins with Piperonyl Butoxide
Pediculosis
Topical treatment of pediculosis capitis (head lice infestation).
An alternative rather than a preferred treatment for pediculosis capitis. Permethrin 1% generally considered the treatment of choice, and malathion 0.5% is recommended when permethrin resistance is suspected.
Base selection of a pediculicide on efficacy (including both pediculicidal and ovicidal activity), safety, cost, availability, ease of application, age of patient, presence of other scalp infections, patient preference, severity of the infestation, potential for transmission, number of recurrences, and the pattern of resistance in the geographic region.
Topical treatment of pediculosis pubis (pubic lice infestation). Considered a pediculicide of choice by CDC and others for treatment of pediculosis pubis, including in HIV-infected patients.
Topical treatment of pediculosis corporis (body lice infestation). In some cases, body louse infestations may be treated by improved hygiene and by decontaminating clothes and bedding by washing at temperatures that kill lice. If the infestation is severe, a pediculicide should also be used (e.g., topical permethrin, topical pyrethrins with piperonyl butoxide, topical malathion, oral ivermectin).
One of several options recommended for treatment of pediculosis corporis in the adjunctive treatment of epidemic (louse-borne) typhus. The causative agent of epidemic typhus (Rickettsia prowazekii) is transmitted person-to-person by Pediculus humanus corporis and thorough delousing (especially among exposed contacts of individuals with typhus) is recommended in epidemic situations.
Scabies
Not effective for treatment of scabies (mite infestation).
Pyrethrins with Piperonyl Butoxide Dosage and Administration
General
Measures to Avoid Reinfestation and Transmission
To avoid reinfestation or transmission of pediculosis or scabies, most experts recommend that clothing and bed linen that may have been contaminated by the infested individual during the 2 days prior to treatment should be decontaminated (machine-washed in hot water and dried in a hot dryer, dry-cleaned, or treated with an appropriate pesticide) or removed from body contact for ≥72 hours.
Although it may not be necessary, items that cannot be laundered or dry-cleaned should be removed from contact and sealed in a plastic bag for 10–14 days.
Combs and brushes used by the infected patient may be disinfected by soaking in hot water (temperature >54°C) for 5–10 minutes; alternatively, they can be soaked in alcohol or a pediculicide for 1 hour.
