Treating Endoparasitic and Ectoparasitic Infestations

Adverse hygienic conditions favor human infestation with multicellular organisms (referred to here as parasites). Skin and hair are colonization sites for arthropod ectoparasites, such as insects (lice, fleas) and arachnids (mites). Against these, insecticidal and arachnicidal agents, respectively, can be used. Endoparasites invade the intestines or even internal organs and are mostly members of the phyla of flatworms and roundworms. They are combated with anthelmintics. 

Antihelmintics. As shown in the table, the newer agents, praziquantel and mebendazole, are adequate for the treatment of diverse worm diseases. They are generally well tolerated, as are the other agents listed. 

Insecticides. Whereas fleas can be effectively dealt with by disinfection of clothes and living quarters, lice and mites require the topical application of insecticides to the infested subject. The following agents act mainly by interfering with the activation or inactivation of neural voltage-gated insect sodium channels. 

Chlorphenothane (DDT) kills insects after absorption of a very low amount, e. g., via foot contact with sprayed surfaces (contact insec- 

Permethrin, a synthetic pyrethroid, exhibits similar antiectoparasitic activity and may be the drug of choice owing to its slower cutaneous absorption, fast hydrolytic inactivation, and rapid renal elimination. 

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