In scabies treatment, oral ivermectin at 200 µg/kg may be associated with slightly lower rates of complete clearance after 1 week compared with 5% permethrin cream, but researchers found little or no difference in complete clearance by weeks 2 and 4.
The literature review included 15 randomized clinical trials with 1,896 patients aged 2 to 80 years (45.22%female).
After 1 week of oral ivermectin treatment compared with permethrin, researchers found slightly lower rates of complete clearance of scabies (RR = 0.65; 95% CI, 0.54-0.78).
They found little or no difference in the rates of complete clearance by week 2 (RR = 0.91; 95% CI, 0.76-1.08) and week 4 (RR = 1; 95% CI, 0.86-1.16).
Furthermore, after week 4, ivermectin may be associated with a slightly greater proportion of participants with at least one adverse event (RR = 1.3; 95% CI, 0.35-4.83).
“Systemic ivermectin treatment may be preferred if proper application of permethrin to the whole body cannot be ensured, or if very large groups of patients need to be treated,” Alexander Nast, MD, from the department of dermatology, venerology and allergology at Charité Universitätsmedizin Berlin, and colleagues wrote.
The researchers concluded that permethrin resistance remains a matter of debate and studies are lacking in this area. – by Abigail Sutton
Disclosures: The authors report no relevant financial disclosures.