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Permethrin and ivermectin (oral and topical) show similar efficacy for treating scabies, with few mild adverse events reported. However, study reporting quality was often poor, limiting confidence in findings.

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Parasitology

Background:

  • Scabies is a widespread, intensely itchy parasitic skin infection.
  • Permethrin and ivermectin are key treatments, particularly in resource-limited settings.

Purpose of the Study:

  • To evaluate the efficacy and safety of permethrin versus ivermectin for scabies treatment.
  • To compare topical permethrin with topical or systemic ivermectin across all age groups.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Included 15 RCTs (1896 participants) comparing permethrin and ivermectin treatments.
  • Primary outcome: complete scabies clearance; secondary: adverse events and re-treatment.

Main Results:

  • Efficacy: Permethrin and ivermectin demonstrated largely comparable clearance rates, with low to moderate certainty evidence.
  • Safety: Few mild adverse events were reported for both treatments; no significant differences were consistently observed.
  • Limitations: Moderate risk of bias and poor reporting quality in most included studies were noted.

Conclusions:

  • Permethrin and ivermectin exhibit similar efficacy in treating scabies.
  • Both treatments are generally safe, with a low incidence of mild adverse events.
  • Improved study reporting is crucial for higher confidence in treatment effect estimates.