Ivermectin is better than benzyl benzoate for childhood scabies in developing countries.
OBJECTIVE
To compare single dose oral ivermectin with topical benzyl benzoate for the treatment of paediatric scabies.


METHODS
An observer-blinded randomized controlled trial was undertaken at Vila Central Hospital, Vanuatu. One hundred and ten children aged from 6 months to 14 years were randomized to receive either ivermectin 200 micro g/kg orally or 10% benzyl benzoate topically. Follow up was at 3 weeks post-treatment. Primary outcome measures were the number of scabies lesions, the itch visual analogue score and nocturnal itch. Secondary outcome measures were the skin's reaction to treatment, the passage of worms in stool and other side effects.


RESULTS
Eighty patients completed the study protocol. There was no significant difference between the two treatments; both produced a significant decrease in the number of scabies lesions seen at follow up. Ivermectin cured 24 out of 43 patients (56%), and benzyl benzoate 19 out of 37 patients (51%) at 3 weeks post-treatment. No serious side effects were noted with either treatment, but benzyl benzoate was more likely to produce local skin reactions (P = 0.004, OR 6.4, 95% CI 1.6-25.0)


CONCLUSIONS
Ivermectin is cheap and effective in the treatment of paediatric scabies. Ivermectin has minimal observed toxicity and has the additional beneficial effects of antiparasitic action in onchocerciasis, filariasis and strongyloidiasis. Ivermectin is better than benzyl benzoate for the treatment of paediatric scabies in developing countries.
Brooks
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PA
Outpatients Department, Vila Central Hospital, Port Vila, Vanuatu. pdbrooks@netscape.net.au
Grace
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D000293:Adolescent; D001565:Benzoates / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D004311:Double-Blind Method; D006801:Humans; D007223:Infant; D007306:Insecticides / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D007559:Ivermectin / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D012532:Scabies / Q000188:drug therapy*; D009514:Vanuatu
D001565:Benzoates; D007306:Insecticides; D007559:Ivermectin; C006723:benzyl benzoate