Intended for healthcare professionals


Single blind, randomised, comparative study of the Bug Buster kit and over the counter pediculicide treatments against head lice in the United Kingdom

BMJ 2005; 331 doi: (Published 11 August 2005) Cite this as: BMJ 2005;331:384
  1. N Hill, head science officer (nigel.hill{at},
  2. G Moor, research paediatric nurse1,
  3. M M Cameron, lecturer1,
  4. A Butlin, school nurse1,
  5. S Preston, study nurse1,
  6. M S Williamson, senior scientist2,
  7. C Bass, research scientist2
  1. 1 Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT
  2. 2 Biological Chemistry Division, Rothamsted Research, Harpenden, Hertfordshire AL5 2JQ
  1. Correspondence to: N Hill
  • Accepted 27 June 2005


Objective To compare the effectiveness of the Bug Buster kit with a single treatment of over the counter pediculicides for eliminating head lice.

Design Single blind, multicentre, randomised, comparative clinical study.

Setting Four counties in England and one county in Scotland.

Participants 133 young people aged 2-15 years with head louse infestation: 56 were allocated to the Bug Buster kit and 70 to pediculicide treatment.

Interventions Home use of proprietary pediculicides (organophosphate or pyrethroid) or the Bug Buster kit.

Main outcome measure Presence of head lice 2-4 days after end of treatment: day 5 for the pediculicides and day 15 for the Bug Buster kit.

Results The cure rate using the Bug Buster kit was significantly greater than that for the pediculicides (57% v 13%; relative risk 4.4, 95% confidence interval 2.3 to 8.5). Number needed to treat for the Bug Buster kit compared with the pediculicides was 2.26.

Conclusion The Bug Buster kit was the most effective over the counter treatment for head louse infestation in the community when compared with pediculicides.


  • Contributors NH initiated the research, secured funding, and led the design of the study; he is guarantor. MMC led the analysis of data and writing the report. GM coordinated the trial and with AB and SP participated in the fieldwork and contributed to writing the report. MSW and CB carried out the analysis of kdr-type resistance mutations.

  • Funding Health and social research grant from the Big Lottery Fund (formerly the National Lottery Charities Board) awarded to Community Hygiene Concern in collaboration with the London School of Hygiene and Tropical Medicine.

  • Competing interests NH has received funding over the past 10 years to screen pediculicides but not products or companies involved in this study.

  • Ethical approval London School of Hygiene and Tropical Medicine research ethics committee, London multicentre research ethics committee, and individual local research ethics committees of the health authorities in each study area.

  • Accepted 27 June 2005
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