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A persistent problem with scabies in and outside a nursing home in Amsterdam: indications for resistance to lindane

J A van den Hoek1, J A van de Weerd, T D Baayen

  • 1Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands.

Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin
|December 2, 2008
PubMed

Insights

Scabies outbreaks in a nursing home showed resistance to standard treatments like lindane and ivermectin. Topical permethrin cream effectively resolved persistent scabies infections, indicating its efficacy against resistant strains.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Parasitology

Background:

  • Scabies outbreaks pose significant challenges in institutional settings like nursing homes.
  • Standard treatments for scabies, including lindane and ivermectin, have shown varying efficacy.
  • Observed recurrences suggested potential drug resistance in scabies mites.

Purpose of the Study:

  • To describe a scabies outbreak in a nursing home.
  • To evaluate the effectiveness of standard scabies treatments.
  • To identify an effective treatment for drug-resistant scabies.

Main Methods:

  • Case description of a scabies outbreak in Amsterdam.
  • Administration of standard treatments (lindane, ivermectin).
  • Subsequent treatment with 5% permethrin cream.

Main Results:

  • Recurrences of scabies were noted after treatment with lindane and ivermectin.
  • A high cure rate was achieved using 5% permethrin.
  • Permethrin demonstrated effectiveness against scabies strains potentially resistant to other treatments.

Conclusions:

  • Standard scabies treatments may face challenges due to drug resistance.
  • Topical 5% permethrin is an effective treatment for scabies, even in cases of suspected resistance.
  • Successful management of scabies outbreaks requires evaluating and adapting treatment strategies.

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