Permethrin 5% (Elimite Cream - Herbert), a synthetic pyrethroid previously available in a 1% concentration (Nix) for treatment of head lice (Medical Letter, 28:89, 1986) and as an aerosol clothing spray (Permanone) for protection against mosquitoes and ticks (Medical Letter, 31:45, 1989), was recently approved by the US Food and Drug Administration for single-application treatment of infestation with Sarcoptes scabiei (scabies).

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.

With increasing travel, immigration, use of immunosuppressive drugs and the spread of AIDS, physicians anywhere may see infections caused by parasites. The table in this document lists first-choice and alternative drugs for most parasitic infections.