A comparative therapeutic evaluation of topical Ivermectin Vs topical Permethrin for the management of scabies
Abstract
Objective: To compare the therapeutic efficacy of topical ivermectin 0.5% vs. topical permethrin 5% cream in the treatment of scabies.
Methods: This was open labelled, parallel group, prospective and comparative clinical study. Depending on the treatment to be received, there were two study groups comprising 50 patients each. Group 1 patients received topical 5 % Permethrin cream on day 1 and repeat application on 1st week follow up and if required then on second week; Group 2 patients received topical 0.5% Ivermectin cream on day 1 and repeat application on 1st week follow up and if required then on second week. The patient were also given antipruritic drug Tablet levocetirizine in a dose of 5 mg once daily given for 2 to 3 weeks. A total of 50 patients in each group were included in the study.
Results: More than half of the patients in both Group 1 (56%) and Group 2 (54%) were below 30 years. More than half of the patients in both Group 1 (54%) and Group 2 (52%) were males. Majority of site of lesions were absent at 2 weeks in both the groups. Moderate and severe itching of lesion became nil at 2 weeks in both the groups. Grade 2 of itching of lesion was in 2% at 2 weeks in both the groups. KOH was positive in 94% patients in Group 1 and in 96% in Group 2 at baseline which decreased to 14% in Group 1 and 18% in Group 2 at 1 week. KOH positivity became nil at 2 weeks in both the groups.
Conclusion: Topical Permethrin 5 % and Ivermectin 0.5 % were equally effective in the treatment of scabies up to 2 weeks.
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References
Orion E, Marcos B, Davidovici B, Wolf R. Itch and scratch: scabies and pediculosis. Clin Dermatol. 2006 May-Jun;24(3):168-75.
The Lancet Global Health Blog: Scabies added to the World Health Organisation list of Neglected Tropical Diseases. (2014), Available at: http://globalhealth.thelancet.com/2014/07/07/scabies-joins-list-whoneglected-tropical-diseases (Last accessed 19 June 2015).
Connors C. Scabies treatment. Northern Territory Disease Control Bulletin. 1994;2:5–6.
Clucas DB, Carville KS, Connors C, Currie BJ, Carapetis JR, Andrews RM. Disease burden and health-care clinic attendances for young children in remote Aboriginal communities of northern Australia. Bull World Health Organ. 2008;86(4):275–81. doi: https://doi.org/10.2471/BLT.07.043034.
Manjhi PK, Sinha RI, Kumar M, Sinha KI. Comparative study of efficacy of oral ivermectin versus some topical antiscabies drugs in the treatment of scabies. J Clin Diagn Res. 2014 Sep;8(9):HC01-4. doi: https://dx.doi.org/10.7860%2FJCDR%2F2014%2F9092.4878. Epub 2014 Sep 20.
Roos TC, Alam M, Roos S, Merk HF, Bickers DR. Pharmacotherapy of ectoparasitic infections. Drugs. 2001;61(8):1067-88.
Glaziou P, Cartel JL, Alzieu P, Briot C, Moulia-Pelat JP, Martin PM. Comparison of ivermectin and benzyl benzoate for treatment of scabies. Trop Med Parasitol. 1993 Dec;44(4):331-2.
Spielman A WM. Arthropods. In: Gorbach SL, Bartlett JG, Blacklow NR. Infectious diseases. 2nd ed. Pennsylvania: W.B. Saunders Company. 1998:p 2499-511.
Chhaiya SB, Patel VJ, Dave JN, Mehta DS, Shah HA. Comparative efficacy and safety of topical permethrin, topical ivermectin, and oral ivermectin in patients of uncomplicated scabies. Indian J Dermatol Venereol Leprol. 2012 Sep-Oct;78(5):605-10. doi: http://www.ijdvl.com/text.asp?2012/78/5/605/100571.
Saqib M, Malik L M, Jahangir M. A comparison of efficacy of single topical permethrin and single oral ivermectin in the treatment of scabies. J Pak Assoc Derma 2012; 22:45-49.
Bachewar NP, Thawani VR, Mali SN, Gharpure KJ, Shingade VP, Dakhale GN. Comparison of safety, efficacy, and cost effectiveness of benzyl benzoate, permethrin, and ivermectin in patients of scabies. Indian J Pharmacol 2009;41:9-14.
Ly F, Caumes E, Ndaw CA, Ndiaye B, Mahé A. Ivermectin versus benzyl benzoate applied once or twice to treat human scabies in Dakar, Senegal: a randomized controlled trial. Bull World Health Organ. 2009 Jun;87(6):424-30.
Chouela EN, Abeldaño AM, Pellerano G, La Forgia M, Papale RM, Garsd A, Balian MC, Battista V, Poggio N. Equivalent therapeutic efficacy and safety of ivermectin and lindane in the treatment of human scabies. Arch Dermatol. 1999 Jun;135(6):651-5.
Usha V, Gopalakrishnan Nair TV. A comparative study of oral ivermectin and topical permethrin cream in the treatment of scabies. J Am Acad Dermatol. 2000 Feb;42(2 Pt 1):236-40.
Sule HM, Thacher TD. Comparison of ivermectin and benzyl benzoate lotion for scabies in Nigerian patients. Am J Trop Med Hyg. 2007 Feb;76(2):392-5.
Wankhade P, Tamboli SB, Deshmukh JB, Rathode PS, Domple VK, DagarVikas. Acomparative Study of Topical Permethrin, Oral Ivermectin and Combination of Permethrin with Ivermectin In Patients Of Scabies. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS.Volume 15, Issue 5 Ver. I (May. 2016), PP 67-72.
Sharma R, Singal A. Topical permethrin and oral ivermectin in the management of scabies: a prospective, randomized, double blind, controlled study. Indian J Dermatol Venereol Leprol. 2011 Sep-Oct;77(5):581-6. doi: http://www.ijdvl.com/text.asp?2011/77/5/581/84063.
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