Ivermectin: new indication. Oral treatment of scabies: simple and effective

(1) Ivermectin is the first oral drug to be licensed in France for the treatment of scabies. (2) In common scabies, three small trials suggest that ivermectin is about as effective as topical preparations. (3) Several cohort studies have shown that ivermectin can control outbreaks of scabies (especially in institutions) and also in endemic areas. (4) There are no clinical trial data on ivermectin in crusted scabies. Case series suggest that combining ivermectin with topical treatments may increase efficacy. (5) Ivermectin seems to have few, mostly mild short-term side effects in adults. There are no reports of ivermectin treatment in infants weighing less than 15 kg or in breast-feeding infants. Data on about 400 pregnant women treated with ivermectin are reassuring. (6) In a small cohort of elderly patients, ivermectin used after topical preparations coincided with excess mortality 6 months later. Subsequent studies were reassuring, but all adverse events (including death) in elderly patients treated with ivermectin must none the less be notified. (7) In practice, oral ivermectin is effective against scabies and is thus an alternative to topical treatments. Its single-dose administration facilitates treatment, especially during outbreaks.