Management of CLM
Among the various treatments, no randomized trials exist comparing their efficacy. Caumes et al1 recommend a single dose of oral ivermectin 12 mg weekly until cure, or oral albendazole 400 mg twice daily for 3 consecutive days. Others recommend ivermectin 200 mcg/kg, repeated once or twice,3 thiabendazole 500 mg 4 times daily for 5 days,4 or even topical thiabendazole 10% cream,5 although creams may be less effective. Topical thiabendazole is a good alternative for young children to avoid the potential side effects of systemic medications.
Folliculitis from the larva may be relatively treatment-resistant, requiring a longer duration of treatment to effect cure (strength of recommendation [SOR]: C).
Outcome and prevention
Both students were treated with ivermectin 15 mg as a single dose, with prompt resolution of symptoms. They were counseled to wear beach shoes and not to sit directly on sand while on the beach.
Additional reading: Brenner MA, Patel MB. Cutaneous larva migrans: the creeping eruption. Cutis 2003; 72:111—115.