Comparative study of efficacy of oral ivermectin versus some topical antiscabies drugs in the treatment of scabies.

BACKGROUND: The conventionally used topical antiscabetics have poor compliance. Ivermectin, an oral antiparasitic drug, has been shown to be an effective scabicide and could be a useful substitute. This study was designed to compare efficacy of oral ivermectin with commonly used topical antiscabies drugs.

MATERIALS AND METHODS: This study was conducted on four groups including 60 patients in each group by simple random sampling. Treatment given in each group was: Group 1: Ivermectin (200 μg/kg body weight) oral in a single dose, Group 2: Topical Permethrin 5% cream single application, Group 3: Topical gamma benzene hexachloride (GBHC) lotion 1% single application and Group 4: Topical Benzyl benzoate (BB) lotion 25% single application. All of the patients were followed for improvement in terms of severity of disease and severity of pruritus at the end of 1(st) wk and 6(th) wk.

RESULTS: Efficacy of ivermectin, permethrin, GBHC and BB lotion considering improvement in severity of pruritus as parameter were 85%, 90%, 75% and 68.33% respectively at 2(nd) follow-up. Similarly considering improvement in severity of lesion as parameter, results were 80%, 88.33%, 71.66% and 65% respectively at 2(nd) follow up. Topical Permethrin (5%) was more effective as compared to topical BB lotion and topical GBHC lotion (p<0.05, significant) but statistical difference between efficacy of topical Permethrin and oral Ivermectin was non-significant (p>0.05).

CONCLUSION: The results suggested that oral Ivermectin and topical Permethrin (5%) were equally efficacious. Oral Ivermectin is well tolerated, non irritant to skin, does not show central nervous system side effects because it does not cross blood brain barrier. So, the good therapeutic response with few side effects seen with oral Ivermectin can be useful in those patients for whom topical treatment is potentially irritant and less well-tolerated.