Dawaa Reference

infectious

Recurrent Intestinal Worm Reinfestation

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

CDC Enterobiasis Guidelines 2020 · Egyptian National Drug Formulary - Antimicrobial 2023 (mebendazole monograph) · MSF Essential Drugs 2024 - albendazole (oral), indications and dosage (msf-essential-drugs-2024.txt, page 27)

Verified against2 documents
  • Egyptian National Drug Formulary - Antimicrobial 2023 (mebendazole monograph)
  • MSF Essential Drugs 2024 - albendazole (oral), indications and dosage (msf-essential-drugs-2024.txt, page 27)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • About a third carry the worm and feel nothing at all
  • Itching around the anus is the leading complaint [itching]
  • Unrelenting itch breaks sleep and can end in insomnia [insomnia · itching]
  • Genitourinary infection in girls and women is described, as is watery diarrhoea [diarrhoea]
  • Abdominal pain, and even appendicitis, can follow worms blocking or inflaming the appendix [abdominal pain]

Signs — what you find (3)

  • Redness of the perianal skin follows the itching and the scratching [itching · redness]
  • Scratch sites may turn red and warm from a shallow bacterial infection
  • Fine thread-like worms are sometimes visible around the anus with no lens at all

Tests (7)

  • Diagnosis is by cellophane tape or a paddle pressed to perianal skin and read under a microscope
  • Ova measure 50 by 30 microns and lie flattened on one side; whole worms may show instead
  • Females run 8 to 13 mm long and males 2 to 5 mm
  • Sample early in the morning, when the yield is highest
  • Only five straight negative mornings exclude it
  • Stool microscopy does not answer the question, the worms reaching stool only now and then
  • Stool is still sometimes analysed to exclude other causes

If not this — what else fits (5)

  • Pruritus ani
  • Pruritus vulvae
  • Atopic dermatitis
  • Perirectal abscess
  • Cellulitis of the skin there

SourceStatPearls "Enterobius Vermicularis" - disease-level clinical article

Presentation findings are traced to the source above.

1

MEBENDAZOLE

1st line

Strength100 mg

Formoral.solid

Adult dose and duration

100 mg single dose, REPEAT a second 100 mg dose after 14 days - Single dose repeated at 14 days

Paediatric dose

(Treatment of patients ≥2 years of age: 100 mg as a single dose; repeat in 2 weeks)

Dose by age
2 years and over:100 mg single dose; repeat in 2 weeks
Dose source

Egyptian National Drug Formulary - Antimicrobial 2023 (mebendazole monograph)

Why

Repeat dose at 14 days is essential to kill newly hatched ova and prevent household cycle reinfestation

Cautions
  • HOUSEHOLD RULE: Treat ALL household members simultaneously regardless of symptoms.
  • Repeat 2nd dose strictly 14 days later (first dose kills adult worms, second dose kills newly hatched eggs).
  • The Egyptian formulary gives mebendazole for adults, adolescents and children over 2 years. Use below 2 years is outside that range - weigh it deliberately rather than by habit.
  • Experience in children <2 years is limited; convulsions have been reported in children <1 year.
Egyptian brands
Egyptian brandManufacturerIndicative price
MEBAMOX 100MG 6 TAB.EL NASR3.25 EGP (0.54/unit)
PENTALMIN 100MG 6 TAB.PHAROPHARMA3.50 EGP (0.58/unit)
VERMIN 100MG 6 TAB.MEMPHIS8.00 EGP (1.33/unit)
ANTIVER 100MG 20*6 TABS.ALEXANDRIA200.00 EGP (33.33/unit)
ANTHELMIN 100MG/5ML SUSP. 30ML? strength differs? different route - not oral solidPHARCO3.50 EGP
PERMAX 100MG/5ML SUSP. 30ML? strength differs? different route - not oral solidEIPICO10.00 EGP
2

ALBENDAZOLE

2nd line

Strength400 mg

Formoral.solid

Adult dose and duration

400 mg orally as a single dose; a second 400 mg dose may be given after 2-4 weeks - Single dose, optionally repeated once at 2-4 weeks

Paediatric dose

Age restriction: minimum 6 months

(Child over 6 months and 10 kg or more: 400 mg as a single dose, as for adults. Child over 6 months but under 10 kg: 200 mg as a single dose. Not below 6 months. Tablets are to be chewed or crushed.)

Dose source

MSF Essential Drugs 2024 - albendazole (oral), indications and dosage (msf-essential-drugs-2024.txt, page 27)

Why

Alternative to mebendazole for recurrent enterobiasis where the household cycle keeps re-seeding. MSF Essential Drugs lists enterobiasis (Enterobius vermicularis) among albendazole's indications and gives the repeat dose directly: the first dose kills the adult worms, the repeat catches what has hatched since.

Cautions
  • HOUSEHOLD RULE: Treat ALL household members simultaneously regardless of symptoms.
  • The repeat dose is what prevents reinfestation. For enterobiasis, MSF Essential Drugs 2024 allows a second dose 2 to 4 weeks later. That is a different interval from the 14 days used for mebendazole above - each drug keeps its own source's interval.
  • Do not give to a child under 6 months (MSF Essential Drugs 2024).
  • Avoid during the first trimester of pregnancy. No contra-indication in breast-feeding.
  • Not for a patient with ocular cysticercosis. May cause gastrointestinal upset, headache or dizziness; seizures have been reported where neurocysticercosis was present but undiagnosed.
  • The Egyptian formulary's albendazole monograph lists only hydatid disease and neurocysticercosis, and its doses are for those - do not read the 15 mg/kg/day figures across. The dose above is MSF's, for enterobiasis.
Egyptian brands
Egyptian brandManufacturerIndicative price
ALBENDAZOLE 400 MG 6 TABSPHARMA CURE PHARMACEUTICALS > PHARMA CURE46.00 EGP (7.67/unit)
ANTIZOLE 100MG/5ML SUSP. 30ML? strength differs? different route - not oral solidALEXANDRIA19.00 EGP
ALZENTAL 20MG/ML SUSP. 20ML? strength differs? different route - not oral solidEIPICO21.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.