Effectiveness of Combined Oral and Topical Ivermectin Compared to Topical Treatments in Patients with Scabies

Abstract

Background: Scabies is a common parasitic skin infestation transmitted mainly through direct skin contact. Permethrin was considered the standard treatment; however, due to increasing resistance against permethrin, recent research investigates the effect of other topical preparations like ivermectin as an alternative treatment. Aim of the study: This study aim to evaluate the efficacy and safety of ivermectin whether its topical alone or combined with oral form of ivermectin in the same time on scabietic lesions compared to permethrin. Patient and method: 236 patients with uncomplicated scabies participated in the study. The study population was selected and divided randomly into three groups. The first group received permethrin, the second group received topical ivermectin, and the third group received a combination of topical and oral ivermectin. Each patient received two doses one week apart. The patients were followed up for the first, second, and fourth week of treatment. Results: At the first week, the group who received the combination of treatments has a significant decrease in both severity of itching and number of lesions, the reduction percentage is (77.6, 53.9%), respectively compared to (61.8, 55.2%) with topical ivermectin and ( 8.3, 19% ) with permethrin. At the 4th week, 15.8% of patients in the combination treatment group reported severe itching, significantly lower than the corresponding values in the other groups. Conclusion: The combination of topical and oral ivermectin is safe and more effective than topical ivermectin or permethrin alone. It achieves a remarkable effect in the first week.