With new school terms starting GPs are beginning to see the Autumn rush of children infected with head lice. It was timely that the BMJ published a systematic review of the clinical efficacy of topical treatments for head lice. Busy GPs have asked
Bandolier
for a short précis of the article.
Methods
The authors set some high standards for searching for studies and including them in their analysis. They even located eleven unpublished trials from Wellcome - comparing malathion and permethrin, though unfortunately the company demanded confidentiality, so they could not be used.
The criteria the authors used for inclusion and exclusion included important general issues like randomisation and blinding, and also a number of methodological issues particular to head lice studies. In the end they included in their analysis seven studies of 21 individual treatments, including placebo and eight compounds. The clinical end-point they chose was absence of viable lice or their eggs at 14 days after (usually) a single application.
Results
Cure rates with treatment with inactive vehicle were about 6%. |
