That's true, it's the PMD's call on treatment.  But the DOH is doing harm by parroting the line that antihelminthics shouldn't be used.  Studies found that there was no harm when the antihelminthics were used in conjunction with prednisolone or other steroid.  DOH as usual, is only repeating a half-truth and perfectly illustrates the saying about how a little knowledge is an extremely dangerous thing.  Hope PMDs in Hawaii are smart enough to read the full scope of the studies unlike DOH.