Ivermectin and permethrin for treating scabies
There is unlikely to be any difference in the efficacy of permethrin compared to systemic or topical ivermectin.
Scabies is an intensely itchy parasitic infection of the skin. It occurs throughout the world, but is particularly problematic in areas of poor sanitation, overcrowding, and social disruption. In recent years, permethrin and ivermectin have become the most relevant treatment options for scabies.
This review examined topical permethrin, topical ivermectin, and systemic ivermectin as a treatment for scabies in women and men of all ages. Efficacy was assessed as complete clearance of skin lesions at different time points after the start of the treatment. Other outcomes were the number of participants re-treated, the number of participants with at least one adverse event, and the number of participants who stopped participating in the study because they experienced an adverse event. Fifteen relevant studies were identified, almost all set in South Asia or North Africa. The studies compared systemic ivermectin with topical permethrin, topical ivermectin with topical permethrin, or systemic ivermectin with topical ivermectin to treat people with scabies. All studies were conducted at a single centre with mostly small numbers of participants per study group. Our confidence in the effect estimates was mostly low to moderate. Poor reporting is a major limitation.
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