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Ivermectin for Sarcoptes scabiei hyperinfestation

S E Huffam1, B J Currie

  • 1Royal Darwin Hospital, Menzies School of Health Research, Darwin, Northern Territory, Australia.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|June 13, 1998
PubMed
Summary
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Oral ivermectin shows effectiveness for crusted scabies, a severe skin infestation. Multiple doses may be needed for cure, and recurrence is common even after treatment completion.

Area of Science:

  • Dermatology
  • Parasitology
  • Infectious Diseases

Background:

  • Crusted (Norwegian) scabies is a severe hyperinfestation of Sarcoptes scabiei.
  • It carries high morbidity and risk of life-threatening bacterial sepsis.

Purpose of the Study:

  • To evaluate the efficacy of oral ivermectin in patients with crusted scabies resistant to topical treatments.

Main Methods:

  • An open-label study involving 20 patients with refractory crusted scabies.
  • Treatment consisted of oral ivermectin (200 mg/kg, 1-3 doses at 14-day intervals) plus topical therapy.

Main Results:

  • 8 patients had a complete initial response, 9 a partial response, and 3 minimal improvement.
  • Three doses of ivermectin cured 80% of cases, but recurrence was observed in at least half.

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Conclusions:

  • Oral ivermectin is effective for treating crusted scabies.
  • Multiple doses are often necessary for a cure.
  • Recurrence is common, occurring 6+ weeks post-treatment.