"A combination of standard-dose oral ivermectin and topical scabicides is recommended for treatment. However, data from randomized clinical trials are lacking, and the probability of cure is uncertain. Ivermectin at higher doses has been effective in the treatment of some parasitic diseases."
"The patients were assigned in a 1:1 ratio to receive oral ivermectin (to be taken with food) at a dose of 400 μg per kilogram of body weight (higher-dose group) or 200 μg per kilogram (standard-dose group) on days 0, 7, and 14, combined with head-to-toe application of 5% permethrin cream on days 0 and 7 and daily application of an emollient cream."
"Cure was observed in 75% of the patients in the higher-dose group and in 82% of those in the standard-dose group (odds ratio for cure, 0.64; 95% confidence interval, 0.25 to 1.67). No safety issues were identified."
A randomized controlled trial evaluated treatment efficacy for severe scabies in adults using two ivermectin dosing regimens combined with topical permethrin. Patients received either higher-dose ivermectin (400 μg/kg) or standard-dose ivermectin (200 μg/kg) on days 0, 7, and 14, along with 5% permethrin cream applications on days 0 and 7, plus daily emollient cream. Cure was defined as absence of mites and mite products confirmed by parasitologic or dermoscopic assessment on days 18 and 21, plus absence of active clinical lesions on day 28. Among 132 patients analyzed, 75% in the higher-dose group and 82% in the standard-dose group achieved cure. No safety concerns emerged, indicating standard-dose ivermectin remains appropriate for severe scabies treatment.
#scabies-treatment #ivermectin-dosing #randomized-clinical-trial #parasitic-skin-disease #permethrin-therapy
Read at The New England Journal of Medicine
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