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Permethrin, topical ivermectin equally effective in treating scabies

Ivermectin cream was as effective as permethrin cream and more effective than oral ivermectin in treating patients with scabies, according to study data.

Researchers in India studied 315 patients (aged 5 to 80 years) with uncomplicated scabies in an open-label, randomized, parallel clinical trial. Patients were randomly assigned to one of three treatment groups: permethrin 5% cream as a single application (n=105; mean age, 23.40 years; 58 males); oral ivermectin 200 mcg/kg as a single dose (n=105; mean age, 21.97 years; 58 males) and ivermectin 1% lotion as a single application (n=105; mean age, 22.52 years; 59 males).

Antihistamine for pruritus was given to all patients. Follow-up was at 1, 2, 3 and 4 weeks, with repeated intervention if remedy did not occur. Clinical cure of lesions was the primary endpoint, with complete relief of pruritus as a secondary endpoint. Chi square test and one-way ANOVA testing using SPSS version 12 were used for statistical analysis.

The permethrin group had a 74.8% cure rate at the end of week 1, compared with 69.3% in the topical ivermectin group and 30% in the oral ivermectin group (P<.05). The permethrin and topical ivermectin groups had 100% cure rates by the end of week 3 compared with 99% in the oral ivermectin group (P=.367).

Forty-eight percent of oral ivermectin patients were free of pruritus, compared with 90.9% of permethrin patients and 95% of topical ivermectin patients at 3 weeks. No patients suffered major adverse events. One patient in the permethrin group developed a temporary burning sensation after drug application. In the oral ivermectin group, two patients suffered mild headache and increased pruritus, which were resolved without additional medication.

“Topical ivermectin is as safe as oral ivermectin and topical permethrin,” the researchers concluded. “The faster cure with permethrin and topical ivermectin would reduce the number of follow-up visits required, thus improving compliance and reducing cost.”