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A Single, Oral Dose of Ivermectin Cures Scabies

Scabies, an infestation with the mite Sarcoptes scabiei, usually responds to a single topical treatment with permethrin or lindane. In some patients, however, the infestation can be difficult to eradicate, even after repeated topical applications. In chronic care facilities, scabies can elude eradication even with the most aggessive topical treatments. Ivermectin, a widely used, orally administered, anthelmintic drug, has been reported to be an effective treatment for scabies. In this open-label study, ivermectin was given as a single oral dose (200 µg per kg of body weight) to patients with scabies.

Subjects included 11 otherwise healthy persons and 11 with HIV infection, 7 of whom had AIDS. No other scabicides had been used in the month before ivermectin therapy or during the one-month follow-up period. Of the 11 patients with uncomplicated scabies, all were cured by 4 weeks after a single dose. In the HIV-infected group, 8 patients were cured by 4 weeks after a single dose. Another 2 patients received a second dose of ivermectin 2 weeks after the first because they were still highly symptomatic; these patients cleared after a total of 4 weeks. Pruritus appeared to resolve more rapidly with ivermectin than it does with topical treatment. No adverse reactions were noted.

Comment: Ivermectin is a very appealing therapy for use in chronic care facilities, where simultaneous oral dosing of residents and personnel can be used to treat scabies outbreaks that affect symptomatic persons as well as asymptomatic carriers. Oral ivermectin also appears to be effective in the treatment of crusted (Norwegian) scabies, especially in HIV-infected patients, which in some cases is impossible to eradicate by topical therapy alone. A combination of aggressive topical therapy combined with oral ivermectin may be the optimal management for crusted scabies.

The use of oral ivermectin in the treatment of scabies is a promising advance. A single-dose, oral treatment that is cost-effective is important for public health. Ivermectin is commercially unavailable in both the United States and Canada; it should be brought to market for this indication.

— NH Shear and RA Johnson

Published in Journal Watch Dermatology September 1, 1995

Citation(s):

Meinking TL et al. The treatment of scabies with ivermectin. N Engl J Med 1995 333 26-30.

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• Where to find Ivermectin
  Mike Dalton, 17 Jul 2009 3:22 PM EST
  If Ivermectin is not available in USA and Canada. Where can I order it from?. Is it possible to order... [more]
• Ivermectin
  N. L. nLyo, 24 Sep 2009 7:59 AM EST
  Please let me know where I can find Ivermectin.
  
  Thank you.