### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi im 18 years old and been suffering threadworm for the past 4 days and have taken two doses of mebendazole but to no effect. The itching is keeping me up all night and seems to be getting worse? Ive had these worms before as a child and and about 8 weeks ago and the treatment worked fine then? Could these worms have built up a resistance to the treatment? and is there anything else i can do? Ive also been sticking to strict hygiene measures. Please help

### output:

Hi & Welcome to Chat Doctor. I appreciate your concern for the recurrent thread worm infection. As such there is documented evidence of these worms developing resistance, it is likely that either you have not taken the taken properly or strict hygiene measures not being followed. The treatment involves two doses of Mebendazole or Albendazole with the second dose being given 2 weeks after the first dose. All your family members and other close contacts should be treated at the same time. Because itching and scratching of the anal area is common in thread worm infection, reinfection can occur easily so good hand hygiene is essential which can be achieved by the following measures:1. Appropriate handwashing (particularly before eating or handling food, after using the toilet, and after changing a diaper)2. Keeping the fingernails clean and short3. Avoiding fingernail-biting4. Avoiding scratching the skin around the anus5. Daily morning bathing removes a large proportion of eggs; showering may be preferred to avoid possible contamination of bath water. 6. Careful handling and frequent changing of underclothing, night clothes, towels, and bedding can help reduce infection, reinfection, and environmental contamination with thread worm eggs. These items should be laundered in hot water, especially after each treatment. Hope to have answered your query. A feedback is appreciated.