Pediculosis capitis (head lice infestations) occur in all age groups, but especially in elementary school children. In most cases, transmission occurs by head-to-head contact. Pharmacologic treatment is recommended for persons with live lice or eggs (nits) within 1 cm of the scalp. Topical pediculicides should be tried first. Oral therapy is occasionally required for refractory infestations.

Topical ivermectin lotion 0.5% (Sklice, and generics), which has been available by prescription since 2012, is now FDA-approved for sale over the counter (OTC) for treatment of head lice in patients ≥6 months old. Ivermectin is also available by prescription as a 1% cream (Soolantra) approved for topical treatment of inflammatory lesions of rosacea and in oral tablets (Stromectol, and generics) for treatment of various parasitic infections.

This article includes recommendations for management of most sexually transmitted infections (STIs) other than HIV and viral hepatitis. Some of the indications and dosages recommended here have not been approved by the FDA (see Table 1).

The text and tables that follow include recommendations for management of sexually transmitted infections (STIs) other than HIV and viral hepatitis. Some of the indications and dosages recommended here have not been approved by the FDA.

Head lice infestation occurs in all age groups, but especially in elementary school children. In most cases, transmission occurs by head-to-head contact.

Many infections can be transmitted during sexual contact. The text and tables that follow include recommendations for management of sexually transmitted infections (STIs) other than HIV, viral hepatitis, and enteric infections. Some of the indications and dosages recommended here have not been approved by the FDA.

The FDA has approved the antiparasitic drug ivermectin in a 0.5% lotion (Sklice – Sanofi Pasteur) as a single-use topical treatment for head lice in patients ≥6 months old. Oral ivermectin (Stromectol – Merck) is effective for treatment of head lice resistant to other therapies, but it has not been approved by the FDA for this indication.

The FDA has approved spinosad 0.9% suspension (Natroba – ParaPro) for topical treatment of head lice infestation in patients ≥4 years old. It is available only by prescription.

The FDA has approved benzyl alcohol lotion, 5% (Ulesfia Lotion - Sciele) for treatment of head lice in patients ≥6 months old. The active ingredient is 5% benzyl alcohol; the vehicle is 5% mineral oil.

Head lice occur in all age groups, but especially in elementary school children during the winter months. Infestations are becoming more difficult to treat because of increasing resistance to the chemical pediculicides commonly used, particularly those that are available over-the-counter (OTC).

Parasitic infections are found throughout the world. With increasing travel, immigration, use of immunosuppressive drugs and the spread of AIDS, physicians anywhere may see infections caused by previously unfamiliar parasites. The table below lists first-choice and alternative drugs for most parasitic infections. The brand names and manufacturers of the drugs are listed in this article.