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J Am Acad Dermatol. 2000 Feb;42(2 Pt 1):236-40.

A comparative study of oral ivermectin and topical permethrin cream in the treatment of scabies.

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  • 1Department of Dermatology and Venereology, Medical College and Hospitals, Trivandrum, India.

Abstract

BACKGROUND:

The conventional antiscabietics have poor compliance. Ivermectin, an oral antiparasitic drug, has been shown to be an effective scabicide and could be a useful substitute.

OBJECTIVE:

This study compares the efficacy of oral ivermectin with topical permethrin cream in the treatment of scabies.

METHODS:

Eighty-five consecutive patients were randomized into 2 groups. Forty patients and their family contacts received 200 microg/kg body weight of ivermectin, and another 45 patients and their family contacts received a single overnight topical application of 5% permethrin cream. Patients were followed up at intervals of 1, 2, 4, and 8 weeks.

RESULTS:

A single dose of ivermectin provided a cure rate of 70%, which increased to 95% with 2 doses at a 2-week interval. A single application of permethrin was effective in 97.8% of patients. One (2.2%) patient responded to 2 applications at a 2-week interval. Permethrin-treated patients recovered earlier.

CONCLUSION:

A single application of permethrin is superior to a single dose of ivermectin. Two doses of ivermectin is as effective as a single application of permethrin. The temporal dissociation in clinical response suggests that ivermectin may not be effective against all the stages in the life cycle of the parasite.

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