Efficacy and tolerance of oral ivermectin in scabies

Abstract

Objective The aim of this open-label study was to investigate the therapeutic effect and adverse reactions of oral ivermectin in scabies patients.Background There is much confusion over reports of efficacy, adverse reactions and relapses after oral treatment of scabies with ivermectin.Methods Nineteen patients, ten otherwise healthy outpatients with scabies, and nine inpatients with scabies and another skin disease (dermatomyositis, 3; pemphigus, 2; bullous pemphigoid, 1 ; pyoderma, I ; HIV, 1; Behqet's disease, 1) were treated with an oral dose of 0.2 mg/kg ivermectin ( I % water solution) on days 1 and 8. The presence of live mites and ova in the patient's skin was investigated before, during and after the treatment.Results None of the 19 patients with scabies had evidence of scabies after the second dose of ivermectin. In seven patients we noted the enhancement of pruritus 24-72 h after the first administration of ivermectin. In three patients the skin manifestation, vesicle-pustular rash increased between the second and the fourth day.Conclusion The advantages of oral ivermectin treatment in scabies patients are: high therapeutic efficacy against Sarcoptes scabiei, good tolerance and influence of the drug on the whole skin surface and on clinical symptoms. The administration of the drug is easy and quick. 0 An open-label study of 19 patients (1 3 males and 0926-9959/98/$ -see front matter P I I SO926-99.59(98)00075-0 0 1998 Elsevier Science B.V. All rights reserved

Management of endemic outbreaks of scabies with allethrin, permethrin, and ivermectin

“…The clinical efficacy is good with rapid clearing of skin lesions and a marked decrease in pruritus. 32 The mortality rate 6 months after treatment did not differ significantly from that seen 30 months before treatment. The data presented by Barkwell and Shields 33 do not support their conclusion of an association between ivermectin and an increased risk of death in elderly patients.…”

Guideline for the diagnosis and treatment of scabies in Japan (second edition)

“…At the same time, adverse reactions to this drug have been reported 63–66 . Major overseas reports are cited in the references 56–66 . In addition, major domestic reports have also been cited 31,67–76 …”

“…A number of reports have been published overseas concerning the efficacy of ivermectin against scabies 55 . Most of these reports affirmed the effectiveness of this drug 56–62 . At the same time, adverse reactions to this drug have been reported 63–66 .…”

Treatment of scabies: newer perspectives

“…29 30 The clinical efficacy is good with good clearing of skin lesions and a marked decrease in pruritus. 31 It is rapidly absorbed and excreted through the faeces. The toxic effect of ivermectin after a single dose for scabies appears to be insignificant.…”