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Re: Pinworms

For what its worth - my 2 cents: (we see pinworms in patients frequently)
-g barden

Michael Sachs wrote:

> How do you treat confirmed or suspected pinworms? => History of seeing a
> pinworm rather than "just itching" although if the history is good enough I
> might treat without visual contact.

> Do you give just one Vermox tablet or do you routinely treat with a second
> dose after two weeks?Do you prescribe for all family members - including
> parents- whether they have symptoms or not?  => One pill, each non-pregnant
> family member, once. I'll put a refill on it but a single pill seems very
> effective.

> Do you insist on examining the child or will you prescribe over the phone
> if the diagnosis sounds likely? => Will do a phone script if mom sounds like
> she knows what she is talking about. I have never had a problem with vermox
> as far as side effects.

> Recently I treated one of my patients over the phone (a note had come home
> from school that pinworms were going around the class, he'd had several
> days of rectal itching, etc.).  He wasn't much better after two weeks so I
> finally examined him.  His tush was really red, I cultured it, and sure
> enough he had peri-rectal strep.   Bactroban cleared it up quickly.
>
> Today (Sunday) I received a call from a family who goes to one of the peds
> I cover with on weekends.  The mom said her six-year old had had several
> days of rectal itching and she saw peri-rectal worms late last night.  How
> would you have handled it (after explaining that even after the Vermox is
> given it still takes several days for the itching to stop):
>
> Call in a script for the whole family?    For either one or two pills each?
> Call in a script for two pills for the child only?
> Call in a script for one pill for the child only?
> Don't prescribe anything on the weekend and tell them they need to call
> their regular peds on Monday? => Whole family, one pill each, no refills.
>

==> I got called one night , 12:30 am, in the middle of a Christmas service by
a panicking mother. Her daughter had WORMS in her bottom! Mom was freaked. No
drug stores open on XMAS eve / XMAS morning, so she drove 20 miles into the
hospital for one vermox tab! I could not begin to convince her otherwise. I
remember the call as one of my most memorable...
-g barden