Mosquito repellents for the traveller: Does picaridin provide longer protection than DEET?

Abstract

Background: This review examines the published laboratory and field tests where the repellents DEET and picaridin have been compared for their efficacy as repellents against mosquitoes. The review is limited to an assessment of whether the duration of protection afforded by picaridin is similar to or better than DEET. Method: Identification and analysis of laboratory and field-based trials published in peer-reviewed journals that compared DEET to picaridin efficacy. Results: Only eight field studies and three laboratory studies met the review criteria for inclusion and most were considered to be of high risk of bias and of lower quality when judged against evidence-based principles. Overall, the studies showed little potential difference between DEET and picaridin applied at the same dosage, with some evidence pointing to a superior persistence for picaridin. Conclusion: Applied dosage is one important variable in determining the persistence of a repellent experienced by users but the maximum concentration in current picaridin formulation is < 30%w/v. Therefore, where only 30% DEET or lower concentrations are available, then on current evidence, it is reasonable to offer DEET or picaridin as a first choice. Where > 50% DEET products are available then the protection time advantage associated with these formulations reasonably can be invoked to consider them as first choice repellents.