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Saturday, March 10, 2012

Combination Treatment with Oral Ivermectin followed by Permethrin Application Gives Best Result in Treatment of Scabies

Posted by Dr Prahallad Panda on 6:59 AM Comments

Scabies is a highly contagious parasitic disease affecting mostly school-going children; caused by a mite called Sarcoptes scabiei.

Photo taken at 100x magnification through a mi...
Image via Wikipedia; Sarcoptes scabiei

Recently, the parasite has shown resistance to application of lindane. Lindane is also responsible for many adverse effects including accidental ingestion and poisoning.
Two other drugs are available for treatment of scabies; single dose oral ivermectin and 5% permethrin application twice with a week's interval. The cure rate for ivermectin regime seen after 2 weeks interval has been 85.9% and that for permethrin after 1 week has been 92.5%.
In a study enrolling 240 patients in dermatology outpatient department of Sina Hospital, Tabriz University of Medical Sciences; it was concluded that single dose of oral ivermectin followed by single topical application of permethrin after 2 weeks interval gives 100% cure rate seen after 4 weeks of completion of treatment.
Twice application of permethrin with a 1-week interval is superior to a single dose of ivermectin; which can be due to the action of ivermectin only on adult parasites whereas permethrin acting on both the adult and egg.
The abstract published in Wiley Online Library can be accessed here .



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