Ivermectin: A Few Caveats Are Warranted Before Initiating Therapy for Scabies

Burkhart, Craig N.; Burkhart, Craig G.

doi:10.1001/archderm.135.12.1549

Cited by 20 publications

(13 citation statements)

References 15 publications

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“…Reported relapses in patients with scabies and observed recurrent scabies in domestic animals support the concept of two oral doses with a 7‐day interval 43,44 . A second oral dose of ivermectin 1 week after the initial treatment is a more reliable treatment option, 22 and shortened the time to successful treatment. This scheduling is suitable for the follows reasons: (i) fertile tunneling scabietic mites feed by ingesting keratinocytes and intercellular fluids within the epidermis; (ii) their eggs hatch every 6–7 days; (iii) the plasma half‐time of orally administrated ivermectin is 36 h; 12 and (iv) the lack of ovocidal action of the drug is hypotized 25 .…”

Section: Mode Of Application In Humansmentioning

confidence: 85%

“…Stimulation of γ‐aminobutiric acid (GABA) release from presynaptic nerve endings and enhancement of the binding to the postsynaptic receptors accomplishes this 20,21 . Ivermectin does not affect synapses gated by other transmitter substances, such as acetylcholine, norepinephrine, and serotonin 22 . In this way nerve impulse conduction ceases and paralysis and death of the parasites ensues (Fig.…”

Section: Mode Of Actionmentioning

confidence: 99%

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Ivermectin: pharmacology and application in dermatology

Dourmishev¹,

Dourmishev²,

Schwartz³

2004

Int J Dermatology

166

104

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Ivermectin is a synthetic derivative of the antiparasitic class of compounds known as avermectins. It is a macrolide endectocide with activity against both endoparasites with cutaneous tropism (Strongyloides stercoralis, Ancylostoma braziliense, Cochliomyia hominivorax, Dermatobia hominis, Filaria bancrofti, Wucheria malayi, Onchocerca volvulus, Loa-loa) and ectoparasites such as Sarcoptes scabies, Pediculus humanus, Demodex folliculorum, and Cheyletiella sp. Ivermectin is of great interest in the treatment of patients with different forms of scabies, head lice, demodecidosis, cutaneous larva migrans, cutaneous larva currens, myiasis, and filariasis.

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Section: Mode Of Application In Humansmentioning

confidence: 85%

Section: Mode Of Actionmentioning

confidence: 99%

Ivermectin: pharmacology and application in dermatology

Dourmishev¹,

Dourmishev²,

Schwartz³

2004

Int J Dermatology

166

104

View full text Add to dashboard Cite

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“…In a community control program for ®lariasis, 400 lgIvm/kg body weight achieved excellent cure rates for scabies. 50 Burkhart and Burkhart 12 have also suggested that a dose of 250 or 400 lg/kg may give better cure rates.…”

Section: Resultsmentioning

confidence: 99%

Review of Ivermectin in Scabies

Vaidhyanathan

2001

Journal of Cutaneous Medicine and Surgery: Incorporating Medical and Surgical Dermatology

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A single oral dose of ivermectin of 200 mg/kg body weight is very effective in the treatment of human scabies. A second dose 7-10 days later substantially improves the cure rate. This suggests that ivermectin may not be effective against all the stages in the life cycle of the parasite. Endemic and epidemic scabies in institutions are better treated with Ivm. Crusted scabies ideally should be treated with a combination of Ivm and topical scabicides. Other standard measures and precautions should be taken. Additional controlled studies using a higher single oral dose or using parenteral or topical forms of Ivm are needed. The safety of Ivm in children less than 5 years old and in pregnant women has to be established. The U.S. FDA has not yet approved the drug for the treatment of human scabies.

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“…This restriction is based on the ability of ivermectin to potentially cross poorly developed bloodbrain barriers. 26 Another restriction was related to the concerns about the excess risk of death in elderly patients. 27 However, this risk has not been confirmed.…”

Section: Discussionmentioning

confidence: 99%