Oral ivermectin for the treatment and prophylaxis of scabies in prison.
BACKGROUND
Oral ivermectin has been widely used to treat various human diseases, such as filariasis, myiasis, larva migrans, strongyloidiasis and scabies (both the common and crusted forms). However, there are only a small number of papers on the effects of this drug for the control of scabies in infested environments. The current study shows the results obtained with the collective treatment of inmates of a public jail.


METHODS
A total of 123 inmates living in a restricted and contaminated environment were evaluated clinically by experienced dermatologists for the assessment of the degree of infestation by Sarcoptes scabiei, and were then treated with oral ivermectin (200-300 micorg/kg single dose repeated after 7 days). Both clothing and environment were disinfected. Patients were re-evaluated after 15 days.


RESULTS
In all, 78% of the inmates were infected upon initial evaluation. Re-evaluation 15 days after repeat treatment revealed a cure rate of 91.05%. Prophylaxis was also highly effective, where 93.2% of the non-infected inmates and virtually all the house staff remained disease-free throughout the study period. Two of the 29 inmates (6.8%) who showed no apparent lesions upon initial examination were found to be infected upon re-evaluation. These patients responded well to a third dose of ivermectin.


CONCLUSIONS
Oral ivermectin at a dose of 300 microg/kg single dose repeated after 7 days proved effective for the treatment and prophylaxis of scabies in an infected institutional environment.
Ribeiro
Fernando de Andrade Quintanilha
Fde A
Departamento de Otorrinolaringologia, Santa Casa School of Medicine of São Paulo, São Paulo, SP, Brazil.
Taciro
Edson
E
Guerra
Marília Ribeiro M
MR
Eckley
Claudia A
CA
D000284:Administration, Oral; D000818:Animals; D000977:Antiparasitic Agents / Q000627:therapeutic use*; D001938:Brazil; D004203:Disinfection; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D008297:Male; D011329:Prisoners; D012532:Scabies / Q000188:drug therapy*; D016896:Treatment Outcome
D000977:Antiparasitic Agents; D007559:Ivermectin