Efficacy of Oral Ivermectin in Treating Patients With Scabies Clinical and Experimental Dermatology

TAKE-HOME MESSAGE

• This cohort study assessed the results of treating patients with scabies with a single dose versus two doses of ivermectin 1 week apart. Single-dose ivermectin was effective in 58% of the patients, whereas the double-dose intervention was effective in 98% of patients.
• A two-dose ivermectin intervention is superior to a single dose of ivermectin, which may be attributed to the life cycle of the scabies mite.

–  Joshua R. Ortego, MD

Abstract

As Sarcoptes scabiei is becoming less sensitive to permethrin, clinicians have started to prescribe oral ivermectin (OI) as a first-line treatment. Guidelines suggest OI 200 µg kg-1 as two doses, 1 week apart. However, the black box of the ivermectin registered in Italy recommends a single dose. To compare these two regimens, we collected 71 cases of scabies and treated them according to this protocol [single-dose group (SDG)]. This population was compared to 68 patients who received two doses 1 week apart [double-dose group (DDG)]. Clearance of the disease was achieved in 98% of DDG patients. In the SDG, treatment was successful in only 58% of patients. This study confirms that the absence of a second intake of OI is one of the main predictors of treatment failure (P < 0.001), which may also increase the likelihood of emerging resistance in S. scabiei.

Clinical and Experimental Dermatology

Oral ivermectin to treat scabies: a comparison of two different regimens

Clin Exp Dermatol 2023 Mar 01;48(3)232-234, R Balestri, M Magnano, SD Infusino, CR Girardelli, T Ioris, G Rech 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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