OMPARING THE EFFICACY OF SYSTEMIC IVERMECTIN VERSUS COMBINED MODALITY

Abstract

Background: Scabies is a contagious parasitic infestation. It is significant health problem worldwide. Various treatment options have been existed but the ideal management modalities are ongoing.
Objectives: To evaluate the efficacy of oral ivermectin versus topical permethrin with the aim of
determination suitable regimen for scabies in Mosul city. Methods: The diagnosis was established by
dermatologists. In total, 220 patients were allocated into two groups. Group I received oral ivermectin,
two doses of 200 µg/kg separated by 1 week. Group II applied permethrin 5% cream overnight, repeated
after 1 week with 2 doses ivermectin. All family contacts were simultaneously treated with permethrin.
Patients were followed after 2 and 4 weeks interval. Results: At second week post therapy, 75% of the
patients in group I and 88% in group II achieved a statistically significant improvement in pruritus as
compared to baseline (P< 0.05). None had severe lesions; the improvement in severity score was
significantly greater in group II (P < 0.05). At 4 weeks, the overall cure rate was 82% in group I and 90%
in group II (no significant different). Both ivermectin tablets and permethrin cream were well tolerated
and no major side effects were demonstrated. Conclusion: Combination of oral ivermectin with topical
permethrin represents a useful alternative option with higher cure rate than single therapy. Oral
ivermectin is a magic remedy for epidemics and large scales, however, permethrin shows rapid onset of
action. Simultaneous treatment of all close contacts and improving personal hygiene can control
spreading of scabies.