Effectiveness of oral ivermectin for eradicating infesting mites in patients of scabies

Authors

  • Syed Dilawar Abbas Rizvi
  • Nadia Iftikhar
  • Fizza Batool

Keywords:

Scabies, ivermectin, Sarcoptes scabiei

Abstract

Objective To evaluate the effectiveness of single and two doses of oral ivermectin in scabies by observing its effect on infesting Sarcoptes scabiei. Patients and methods This quasi experimental study, after approval of the hospital ethical committee, was conducted at the Skin Centre, Military Hospital, Rawalpindi, from September 2009 to August 2010. Fifty patients with scabies of up to two month duration having at least ten burrows/papules/nodules each with a visible mite were included in the study. Patients with other concomitant illnesses, pregnancy, lactation and those who had been treated with antiscabies medicines in the previous two months were excluded. Patients with more than six household contacts were also excluded from the study. Patients were given oral ivermectin 200μg/kg (Mectis®). Patients were followed up after a week and previously identified lesions were explored for a living mite. If a living mite was extracted from a lesion, the patient was prescribed another dose of oral ivermectin. At second follow up after a week, demonstration of living mites was considered as treatment failure and the patient was prescribed 5% permethrin cream for topical application. Final review of patients was carried out at the end of fourth week. Results Out of 50, in 22 (44%) patients, a living mite was isolated at one week follow up. At the end of second week, a living Sarcoptes scabiei was found in 11 (22%) patients. All of these 11 nonresponders were treated with topical application of 5% permethrin lotion. At the end of four weeks 49 patients reported for follow up without any identifiable living mite. One patient who had no mite at the end of first and second week did not report back after four weeks. Conclusion Oral ivermectin is a convenient remedy for scabies with a cure rate of 56 % after a single dose and 78% after two doses, a week apart. 

References

Jacobson CC, Abel E A, Parasitic infestations. J Am Acad Dermatol 2007; 56: 1026-43.

Iqbal J, Shahid M, Mann MA. Scabies; Oral ivermectin as the treatment. Professional Med J 2009; 16: 263-9.

Khan I, Yasmin R. Ivermectin in the treatment of scabies. J Pak Assoc Dermatol 2007; 17: 78-83.

Buffet M, Dupin N. Current treatments for scabies. Fundamental Clin Pharmacol 2003; 17: 217-25.

Glaziou P, Cartel JL, Alzieu P et al. Comparison of ivermectin and benzyl benzoate for treatment of scabies. Trop Med Parasitol 1993; 44: 331-2.

Dourmishev AL, Dourmishev LA, Schwartz RA. Ivermectin: pharmacology and application in dermatology. Int J Dermatol 2005; 44: 981-8.

Burn DA. Diseases caused by arthropods and other noxious animals. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook’s Textbook of Dermatology, 8th edn. London: Wiley-Blackwell; 2010. P. 38.36-45.

Brooks PA, Grace RF. Ivermectin is better than benzyl benzoate for childhood scabies in developing countries. J Paediatr Child Health 2002; 38: 401-4.

Meinking TL, Taplin D, Hermida JL et al. The treatment of scabies with ivermectin. N Engl J Med 1995; 333: 26-30.

Dourmishev A, Serafimova D, Dourmishev L. Efficacy and tolerance of oral ivermectin in scabies. J Eur Dermatol Venereol 1998; 11: 247-51.

Offidani A, Cellini A, Simonetti O, Fumelli C. Treatment of scabies with ivermectin. Eur J Dermatol 1999; 9: 100-1.

Currie BJ, Harumal P, McKinnon M, Walton SF. First documentation of in vivo and in vitro ivermectin resistance in Sarcoptes scabiei. Clin Infect Dis 2004; 39: e8-e12, 1, 2.

Mounsey KE, Holt DC, McCarthy JS et al. Longitudinal evidence of increasing in vitro tolerance of scabies mites to ivermectin in scabies-endemic communities. Arch Dermatol 2009; 145: 840-1.

Chouela EN, Abeldano AM, Pellerano G et al. Equivalent therapeutic efficacy and safety of ivermectin and lindane in the treatment of human scabies. Arch Dermatol 1999; 135: 651-5.

Downloads

Published

2016-12-22

How to Cite

1.
Rizvi SDA, Iftikhar N, Batool F. Effectiveness of oral ivermectin for eradicating infesting mites in patients of scabies. J Pak Assoc Dermatol [Internet]. 2016Dec.22 [cited 2024Nov.2];21(2):87-92. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/447

Issue

Section

Original Articles

Most read articles by the same author(s)