Bug Buster for Head Lice

Abstract

Setting: Academic-driven, community-recruited patients from 4 counties in England and 1 county in Scotland after information has been widely distributed to general practitioners (GPs), local pharmacies, primary schools, and parents’ meetings. Patients: Young people aged 2 to 15 years with head lice infestation. Intervention: Each participating GP was assigned an individual randomization list at the start of the trial. Patients were randomized to (1) home use of the Bug Buster kit (4 sequential applications combed on wet, conditioned hair at 3-day intervals) or (2) a single application of a pediculicide (either 0.5% aqueous malathion or 1% aqueous permethrin). Main Outcome Measure: Presence of head lice 2 to 4 days after end of treatment: day 5 for the pediculicides and day 15 for the Bug Buster kit. Results: A total of 133 patients were randomly assigned to treatment with Bug Buster kit (62 patients) or pediculicide (71 patients). One patient was excluded for also using an insecticide, and 6 participants were lost to follow-up. At the time of evaluation, 32 (57%) of 56 patients were cured in the Bug Buster kit group vs 9 (13%) of 70 in the pediculicide group, and 5 (17%) of 30 and 4 (10%) of 40 for malathion and permethrin, respectively (relative risk, 4.4; 95% confidence interval, 2.3-8.5; number needed to treat, 2.26). The significant difference remained after extreme case analysis. Authors’ Conclusions: The Bug Buster kit is the most effective over-the-counter treatment for head lice infestation in the community compared with pediculicides.