Table 1 Treatment for pediculosis capitis infestation.

Citation	Study group	Study type (level of evidence)	Outcome	Key results	Comments
Roberts	74 children (aged 3–14 years)	Randomised	Presence of live	Cure rate was 38% for	Area where study was conducted
et al	randomised to wet combing	controlled trial	lice 7 days post	wet combing and 78%	known to have intermediate
(2000)2	(Bug Buster Kit) every 3–4	(level 1b)	treatment	for malathion. Cure 2.8	resistance to malathion. Only 50%
	days for 2 weeks or			times more likely with	of patients fully compliant (no
	treatment with 0.5% malathion			malathion (95% CI 1.0	significant difference between
	lotion (2 applications 7 days			to 5.2, p = 0.0006).	treatment groups). Majority of
	apart) without use of a nit				individuals in wet combing
	comb. Treatment carried out				group used treatment for ⩾14 days
	by parents at home.				(81%). No side effects observed.
Bingham	15 college students randomised	Randomised	Presence of live	Cure rate was 75% for	40% of lice collected showed
et al	to wet combing (Bug Buster	controlled trial	lice on day 14	wet combing and 43%	resistance to malathion and
(2000)3	Kit) every 3 days for	(pilot) (level 1b)	after starting	for insecticide (no	carbaryl. Drop out rate high (40%).
	2 weeks or single treatment		treatment	statistical significance
	with insecticide (permethrin*).			reached).
	First treatment was carried out
	by researcher, subsequent
	treatment by parents.
Plastow	30 children (aged 4–16 years)	Randomised	Presence of live	Cure rate was 53% for	Children in lotion arm more
et al	randomised to wet combing	controlled trial	lice on day 14	wet combing and 13%	heavily infested than in wet
(2001)4	(Bug Buster Kit) every 3 days	(level 1b)	after starting	for phenothrin (p = 0.05).	combing arm. Local resistance
	for 2 weeks or treatment with		treatment	Number needed to treat	pattern unknown. All patients
	phenothrin lotion (2			2.5 (95% CI 1.5 to 16.7)	completed the study and
	applications 7 days apart)			for wet combing. All	had full treatment as per protocol.
	without use of a nit comb.			children were cured after	No side effects reported
	Treatment was carried out by			prolonged treatment with
	nurse.			wet combing (maximum
				duration 24 days).
Vander	38 school children treated with	Cohort study/	Presence of live	Cure rate was 47% for	Further children included in the
Stichele	wet combing (sessions every 4–	poor quality	lice and/or nits on	wet combing and 64%	report had combined treatments,
et al	5 days for 2 weeks) and 25	(level 4)	day 14 after	for insecticides	alternative treatments or no
(2002)5	treated with insecticide alone.		starting treatment.	(combined figure).	treatment. Local resistance
	1% permethrine applied for 10		Inconsistent	No statistical	pattern unknown.
	min, 0.5% malathion for 12 h		definition of cure	comparison made.
	or pyrethrine for 30 min.		(varied between
	Parents chose initial		schools)
	treatment. If no cure on day 7,
	same insecticide applied again.
	If no cure at day 14 another
	substance was used.
Hill	126 children (aged 2–15 years)	Randomised	Presence of live	Cure rate was 57% for	Only 22% of participants had
et al	randomised to wet combing	controlled trial	lice 2–4 days	wet combing and 13%	pediculosis for the first time (88%
(2005)6	(Bug Buster Kit) four sessions	with high risk of	post treatment	for insecticides.	repeated infestation). Allocation
	with 3 days between sessions or	bias (level 1b−)		“Relative risk” 4.4 (95%	concealment was inadequate. Lice
	single dose treatment with 0.5%			CI 2.3 to 8.5) with wet	from participants tested by
	malathion lotion or treatment			combing when compared	molecular methods, confirmed high
	with 0.5% permethrin.			with both pediculocides	proportion of resistance against
	Treatment carried out by			combined.	pyrethroids. Study used newer
	parents at home.				version of the Bug Buster Kit.

*Information on which insecticide was used in this study kindly provided by the author (personal communication).