What is a possible mechanism of pediculicidal resistance in pediculosis and pthiriasis (lice infestation)?

Updated: Aug 16, 2019
  • Author: Lyn C C Guenther, MD, FRCPC, FAAD; Chief Editor: Michael Stuart Bronze, MD  more...
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Resistance of lice to the most commonly used medications for treatment of infestation (permethrin and pyrethrin) is increasing. [49, 50, 51, 52] Resistance has been reported in the United States as well as among countries in South America and Europe.

A possible mechanism of drug resistance development includes mutations of target enzymes (eg, acetylcholinesterase) so that the enzymes no longer bind the organophosphate permethrin with the same affinity. Another possible mechanism is increasing the metabolism of the insecticides through an increase in monooxygenase enzyme activity, turning them into harmless compounds before they can cause damage. [53, 54, 55, 56, 57, 58]

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