Comparative Study of Efficacy of Oral Ivermectin Versus Some Topical Antiscabies Drugs in the Treatment of Scabies
19
Citation
15
Reference
10
Related Paper
Citation Trend
Abstract:
The conventionally used topical antiscabetics have poor compliance. Ivermectin, an oral antiparasitic drug, has been shown to be an effective scabicide and could be a useful substitute. This study was designed to compare efficacy of oral ivermectin with commonly used topical antiscabies drugs.This study was conducted on four groups including 60 patients in each group by simple random sampling. Treatment given in each group was: Group 1: Ivermectin (200 μg/kg body weight) oral in a single dose, Group 2: Topical Permethrin 5% cream single application, Group 3: Topical gamma benzene hexachloride (GBHC) lotion 1% single application and Group 4: Topical Benzyl benzoate (BB) lotion 25% single application. All of the patients were followed for improvement in terms of severity of disease and severity of pruritus at the end of 1(st) wk and 6(th) wk.Efficacy of ivermectin, permethrin, GBHC and BB lotion considering improvement in severity of pruritus as parameter were 85%, 90%, 75% and 68.33% respectively at 2(nd) follow-up. Similarly considering improvement in severity of lesion as parameter, results were 80%, 88.33%, 71.66% and 65% respectively at 2(nd) follow up. Topical Permethrin (5%) was more effective as compared to topical BB lotion and topical GBHC lotion (p<0.05, significant) but statistical difference between efficacy of topical Permethrin and oral Ivermectin was non-significant (p>0.05).The results suggested that oral Ivermectin and topical Permethrin (5%) were equally efficacious. Oral Ivermectin is well tolerated, non irritant to skin, does not show central nervous system side effects because it does not cross blood brain barrier. So, the good therapeutic response with few side effects seen with oral Ivermectin can be useful in those patients for whom topical treatment is potentially irritant and less well-tolerated.Keywords:
Lotion
Background Scabies is a common health problem worldwide. Among available topical treatment modalities, 5% permethrin is the most effective scabicide with few side effects. Ivermectin is the only oral scabicide available. It is effective, inexpensive and easy to administer with no known drug interactions and limited side effects. Objective To compare the efficacy of topical permethrin and oral ivermectin in treatment of scabies. Patients and methods In this quasi-experimental study, a total of 120 patients of scabies were enrolled and randomly divided in 2 groups of 60 each. Topical 5% permethrin whole body application for 10-12 hours and oral ivermectin as 200µg/kg were used in groups A and B, respectively. In both groups, history, examination and microscopy were carried out at day 0, 7 and day 14. Response to treatment was judged on following parameters: decrease in severity of pruritus, nonappearance of new lesions and absence of burrows. Each parameter was scored and sum total of individual scores was used to determine the efficacy. Results Mean age in group A (permethrin) was 29.45 + 9.72 years and in group B (ivermectin) was 31.45 + 12.78 years. In both groups, 66.7% patients showed complete cure. Conclusion There is no significant difference regarding efficacy of topical permethrin and oral ivermectin when used in treatment of scabies.
Cite
Citations (3)
Abstract Scabies is an ectoparasitic, highly contagious skin disease caused by a mite called Sarcoptes scabiei . The insecticides ivermectin and permethrin are commonly used for treatment of scabies. This study aimed at comparing the efficacy of oral ivermectin with topical permethrin in treating scabies. Two hundred and forty‐two patients with scabies attending the dermatology outpatient department of Sina Hospital, Tabriz University of Medical Sciences were admitted. Patients were divided into two groups randomly. The first group and their family contacts received 5% permethrin cream and the other received oral ivermectin. Treatment was evaluated at intervals of 2 and 4 weeks. A single dose of ivermectin provided a cure rate of 85.9% at a 2‐week interval, which increased to 100% after crossing over to the permethrin group at a 4‐week interval. Twice application of permethrin with a 1‐week interval was effective in 92.5% of patients, which increased to 94.2% after crossing over to the ivermectin group at a 4‐week interval. Permethrin‐treated patients recovered earlier. Twice application of permethrin with a 1‐week interval is superior to a single dose of ivermectin. The temporal dissociation in clinical response suggests that ivermectin may not be effective against all the stages in the life cycle of the parasite.
Sarcoptes scabiei
Outpatient clinic
Antiparasitic agent
Cite
Citations (89)
Scabies is commonly treated with acaricides but the treatment of choice is still controversial. This study aimed at comparing the efficacy of oral ivermectin vs. lindane lotion 1% for the treatment of scabies. Four hundred fourty patients with scabies were enrolled, and randomized into two groups: the first group received a single dose of oral ivermectin 200 microg/kg body weight, and the second group were treated with two applications of topical lindane lotion 1%, with a 1-week interval. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Single dose of oral ivermectin provided a cure rate of 63.6% at the 2-week follow-up, which increased to 81.8% at the 4-week follow-up after repeating the treatment. Treatment with two applications of lindane lotion 1%, with a 1-week interval between them, was effective in 45.4% of patients at the 2-week follow-up, which increased to 63.6% at the 4-week follow-up after this treatment was repeated. Single dose ivermectin was as effective as two applications of lindane lotion 1% at the 2-week follow-up. After repeating the treatment, ivermectin was superior to lindane lotion 1% at the 4-week follow up.
Lotion
Lindane
Cite
Citations (16)
Few studies have compared ivermectin directly with topical agents in developing countries. We compared the effectiveness of oral ivermectin (200 μg/kg) with topical 25% benzyl benzoate and monosulfiram soap in 210 subjects of age 5 to 65 years with scabies. Subjects with persistent lesions after 2 weeks received a second course of treatment. All lesions had resolved after 2 weeks in 77 of 98 (79%) subjects treated with ivermectin and in 60 of 102 (59%) subjects treated topically ( P = 0.003). The improvement in severity score was greater in the ivermectin group than in the topical treatment group ( P < 0.001). The overall cure rate after 4 weeks was 95% in the ivermectin group and 86% in the topical treatment group ( P = 0.04). Compared with topical benzyl benzoate and monosulfiram in the treatment of scabies, ivermectin was at least as effective and led to more rapid improvement.
Benzyl benzoate
Lotion
Benzocaine
Cite
Citations (49)
Human scabies is caused by an infestation of the skin by the human itch mite (Sarcoptes scabiei va. hominis). It is commonly treated with topical insecticides, but the treatment of choice is still controversial. The aim of this study is to compare the efficacy of topical ivermectin vs. permethrin 2.5% cream for the treatment of scabies. In total, 380 patients with scabies were enrolled, and randomized into two groups: the first group received 1% ivermectin applied topically to the affected skin at a dose of 400 microg/kg, repeated once the following week, while the second group received permethrin 2.5% cream and were told to apply this twice at one week intervals. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Two applications of topical ivermectin provided a cure rate of 63.1% at the 2-week follow-up, which increased to 84.2% at the 4-week follow-up after repeating the treatment. Treatment with two applications of permethrin 2.5% cream with a 1-week interval between them was effective in 65.8% of patients at the 2-week follow-up, which increased to 89.5% at the 4-week follow-up after this treatment was repeated. Two application of ivermectin was as effective as two applications of permethrin 2.5% cream at the 2-week follow-up. After repeating the treatment, ivermectin was as effective as permethrin 2.5% cream at the 4-week follow up.
Sarcoptes scabiei
Cite
Citations (29)
Antiparasitic agent
Cite
Citations (27)
Objective: There are different medications for the treatment of scabies but the treatment of choice is still controversial. This study aimed at comparing the efficacy of topical ivermectin versus malation 0.5% lotion for the treatment of scabies. Methods: In total, 340 patients with scabies were enrolled, and randomized into two groups: the first group received 1% ivermectin applied topically to the affected skin and the second group received topical malation 0.5% lotion and were told to apply this twice with 1 week interval. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Results: Two application of topical ivermectin provided a cure rate of 67.6% at the 2-week follow-up, which increased to 85.2% at the 4-week follow-up after repeating the treatment. Treatment with two applications of malation 0.5% lotion was effective in 44.1% of patients at the 2-week follow-up, which increased to 67.6% at the 4-week follow-up after this treatment was repeated. Conclusion:Two application of ivermectin was as effective as single applications of malation 0.5% lotion at the 2-week follow-up. After repeating the treatment, ivermectin was superior to malation 0.5% lotion at the 4-week follow up.
Lotion
Cure rate
Cite
Citations (16)
Human scabies is caused by an infestation of the skin by the human itch mite (Sarcoptes scabiei var. hominis). The aim of this study is to compare the efficacy and safety of permethrin 5% lotion with oral ivermectin for the treatment of scabies. In total, 60 patients with scabies were enrolled, and randomized into two groups: The first group and their family contacts received 5% permethrin cream twice with a one week interval, and the other received a single dose of oral ivermectin. Treatment was evaluated at intervals of 2 and 4 weeks. A single dose of ivermectin provided a cure rate of 62.4%, which increased to 92.8% with 2 doses at a 2-week interval. Treatment with two applications of permethrin with a one week interval was effective in 96.9% of patients. Permethrin-treated patients recovered earlier. Two applications of permethrin with a one week interval is more effective than a single dose of ivermectin. Two doses of ivermectin is as effective as a single application of permethrin.
Sarcoptes scabiei
Lotion
Cite
Citations (29)
Background: Scabies is a contagious infestation transmitted by skin-to-skin contact and sometimes by contact with contaminated material.The scabies mite burrows into the skin, producing a papular rash and severe itch at typical sites of predilection.Methods: We systematically reviewed the literature to compare the efficacy of various anti-scabies agents, including a calculation of relative risks and confidence intervals.Results: A literature search yielded 596 initial hits; after screening in accordance with the defined inclusion and exclusion criteria, 16 studies were selected for this review.Among topical treatments for scabies, permethrin was equally effective or more effective than crotamiton or benzyl benzoate.In a comparison of topical versus systemic treatment, topical permethrin and systemic ivermectin did not differ substantially in efficacy (7 comparative studies revealed no difference; one revealed a difference in favor of permethrin).Comparative trials of topical benzyl benzoate versus systemic ivermectin yielded inconsistent findings.Single and double administrations of ivermectin were similarly effective.In trials involving entire populations with a high prevalence of scabies, systemic ivermectin was found to be superior to topical permethrin.Conclusion: There are hardly any differences in efficacy between the available treatments for scabies.Single administrations of permethrin 5%, crotamiton 10%, and systemic ivermectin are all comparably effective.There are differences in the frequeny and ease of application as well as when eradicating scabies in populations with a high prevalence.
Benzyl benzoate
Cite
Citations (50)
Background Scabies is a common parasitic infestation that is an important public-health problem in many resource-poor regions. It is commonly treated with the insecticides ivermectin and permethrin. Aim To compare the efficacy and safety of oral ivermectin vs. lindane lotion 1% for the treatment of scabies. Methods In total, 148 patients with scabies were enrolled, and were randomized into two groups: the first group received a single dose of oral ivermectin 200 μg/kg body weight, and the second group were treated with two applications of topical lindane lotion 1%, with a 1-week interval between applications. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Results A single dose of ivermectin provided a cure rate of 60.8% at the 2-week follow-up, which increased to 89.1% at the 4-week follow-up. after crossing over to the lindane lotion 1% group. Treatment with two applications of lindane lotion 1%, with a 1-week interval between them, was effective in 47.2% of patients at the 2-week follow-up, which increased to 72.9% at the 4-week follow-up after this treatment was repeated. Conclusions A single dose of ivermectin was as effective as two applications of lindane lotion 1% at the 2-week follow-up. After repeat treatment, ivermectin was superior to lindane lotion 1% at the 4-week follow up. The delay in clinical response with ivermectin suggests that it may not be effective against all the stages in the life cycle of the parasite.
Lindane
Lotion
Cite
Citations (14)