Published online December 31, 2007
PEDIATRICS Vol. 121 No. 1 January 2008, pp. 222 (doi:10.1542/peds.2007-3116)
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Pediculosis Capitis (Head Lice)
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LETTER TO THE EDITOR

Head Lice, Resistance, and Malathion

Kirstin Ross, PhD
Department of Environmental Health
School of Medicine
Flinders University
Adelaide 5001, South Australia

To the Editor.—

I read with interest the article "Therapy for Head Lice Based on Life Cycle, Resistance, and Safety Considerations."1 Resistance was a major focus of the article; however, Lebwohl et al merely stated that "[m]alathion resistance has not been reported in the United States."1 The authors failed to report that this has not been the overseas experience, where malathion has been continually available as a head lice treatment. Downs et al2 (United Kingdom) reported "high" head lice resistance to malathion, supporting evidence first presented in 1972.3 The Australian experience has been similar to that of the United Kingdom, with case-study–based4 and laboratory-based5 evidence of head lice resistance to malathion.

Although Lebwohl et al noted that malathion was reintroduced to the US market in 1998, they did not acknowledge the possibility that the historical prohibition of malathion might be the cause of the susceptibility of head lice in the US compared with other countries. It seems likely that the US head lice will follow a similar resistance pattern over time to that exhibited by head lice in the United Kingdom and Australia. This inadequate examination of resistance to malathion might be merely an oversight; however, the authors left themselves open to a charge of deception by omission, given the conflict of interest (the third author of the article serves as vice president of and is a major shareholder in the sole pharmaceutical company that manufactures and markets Ovide6).

REFERENCES

  1. Lebwohl M, Clark L, Levitt J. Therapy for head lice based on life cycle, resistance, and safety considerations. Pediatrics. 2007;119 :965 –974[Abstract/Free Full Text]
  2. Downs AMR, Stafford KA, Harvey I, Coles GC. Evidence for double resistance to permethrin and malathion in head lice. Br J Dermatol. 1999;141 :508 –511[CrossRef][Web of Science][Medline]
  3. Silverton N. Malathion-resistant Pediculosis capitis. Br Med J. 1972;3 :646 –647[Free Full Text]
  4. Bailey AM, Prociv P. Persistent head lice following multiple treatments: evidence for insecticide resistance in Pediculus humanus capitis. Australas J Dermatol. 2000;41 :250 –254[CrossRef][Medline]
  5. Hunter JA, Barker SC. Susceptibility of head lice (Pediculus humanus capitis) to pediculicides in Australia. Parasitol Res. 2003;90 :476 –478[CrossRef][Web of Science][Medline]
  6. Weil WB. Therapy for head lice. Pediatrics. 2007;120 :688[Free Full Text]
PEDIATRICS (ISSN 1098-4275). ©2008 by the American Academy of Pediatrics

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This Article
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Right arrow Infectious Disease & Immunity
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Pediculosis Capitis (Head Lice)
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