COMPARING THE EFFICACY OF SYSTEMIC IVERMECTIN VERSUS COMBINED MODALITY

Abstract

Background: Scabies is a contagious parasitic infestation. It is significant health problem worldwide. Various treatment options have been existed but the ideal management modalities are ongoing.
Objectives: To evaluate the efficacy of oral ivermectin versus topical permethrin with the aim of determination suitable regimen for scabies in Mosul city.

Methods: The diagnosis was established by dermatologists. In total, 220 patients were allocated into two groups. Group I received oral ivermectin, two doses of 200 µg/kg separated by 1 week. Group II applied permethrin 5% cream overnight, repeated after 1 week with 2 doses ivermectin. All family contacts were simultaneously treated with permethrin. Patients were followed after 2 and 4 weeks interval.

Results: At second week post therapy, 75% of the patients in group I and 88% in group II achieved a statistically significant improvement in pruritus as compared to baseline (P< 0.05). None had severe lesions; the improvement in severity score was significantly greater in group II (P < 0.05). At 4 weeks, the overall cure rate was 82% in group I and 90% in group II (no significant different). Both ivermectin tablets and permethrin cream were well tolerated and no major side effects were demonstrated.

Conclusion: Combination of oral ivermectin with topical permethrin represents a useful alternative option with higher cure rate than single therapy. Oral ivermectin is a magic remedy for epidemics and large scales, however, permethrin shows rapid onset of action. Simultaneous treatment of all close contacts and improving personal hygiene can control spreading of scabies.