Clinical efficacy and safety of topicalversusoral ivermectin in treatment of uncomplicated scabies

Abstract

Many medications are available for scabies treatment including oral and topical ivermectin. However, studies comparing these two forms as a scabies treatment are few. This study compares efficacy and safety of topical versus oral ivermectin as scabies treatment. The study included 62 confirmed uncomplicated scabies patients, divided into: Group I (32 patients, received topical ivermectin) and Group II (30 patients, received oral ivermectin). Patients were assessed, clinically and by KOH smear at 1, 2 and 4 weeks. Treatment was repeated after one week in patients with persistent infection. Adverse events were recorded. Most patients (87.5% and 73.5% in group I and group II respectively) were symptom free after a single treatment. A second treatment was required in 4 patients of group I and 8 patients of group II. However, 2 weeks after treatment symptoms and signs completely resolved in all cases with no recurrence at 4 weeks. This study suggests that both topical and oral ivermectin are safe and equally effective in treatment of uncomplicated scabies. Single treatment, whether topical or oral, is associated with high cure rate in a week post treatment. However, repeating treatment after one week may be required to achieve 100% cure.

Ivermectin and permethrin for treating scabies

“…Seven studies compared two treatment groups. Five of these studies evaluated topical permethrin and systemic ivermectin ( Usha 2000 ; Mushtaq 2010 ; Saqib 2012 ; Rohatgi 2013 ; Wankhade 2013 ); one study compared topical ivermectin with systemic ivermectin ( Ahmad 2016 ); and the remaining study compared one versus three treatments of systemic ivermectin ( Macotela‐Ruiz 1996 ).…”

“…The oldest included study was conducted from 1993 to 1995 and was published in 1996 ( Macotela‐Ruiz 1996 ), while the three most recent ones were published in 2016 ( Abdel‐Raheem 2016 ; Ahmad 2016 ; Wankhade 2016 ).…”

“…The sample size varied from 62, in Ahmad 2016 , to 315, in Chhaiya 2012 . In two studies the numbers of randomized participants per study group were not reported ( Mushtaq 2010 ; Wankhade 2013 ).…”

“…In the study by Abdel‐Raheem 2016 , the mean age of the 200 participants who completed the study was 25.33 years (standard deviation (SD) 12.84). The mean age at baseline of the 62 randomized participants in the study by Ahmad 2016 was 21.8 years (SD 15). Macotela‐Ruiz 1996 did not report the age of participants, but stated a mean age of 12 and 16 years for male and female participants, respectively, in the group treated with one dose of ivermectin 250 μg/kg body weight, and a mean age of 18 and 20 for male and female participants, respectively, in the three‐dose group.…”

Escabiose: Revisão e Foco na Realidade Portuguesa

“…45 Quanto ao uso tópico de ivermectina na escabiose, um estudo de 2016, que incluiu 62 doentes, mostrou que a ivermectina a 1% é uma formulação segura e eficaz no tratamento de escabioses não-complicadas, embora sejam necessários futuros ensaios clínicos deste produto. 46 A ivermectina oral, para uso em humanos, não está comercializada em Portugal, mas poderá ser obtida na forma de manipulado.…”