title: Topical permethrin and oral ivermectin in the management of scabies: a prospective, randomized, double blind, controlled study.
abstract: BACKGROUND
  Scabies is a highly contagious and intensely pruritic parasitic infestation. It is a re-emerging infection in the new millennium especially with HIV pandemic and a significant health problem in developing countries. Various treatment modalities have been used since time immemorial but the search for an ideal scabicide is ongoing.
  
  
  OBJECTIVE
  In this study, we compared the therapeutic efficacy of single application of topical 5% permethrin with oral ivermectin (200 μg/kg/dose) in a single-dose and a two-dose regimen in patients with scabies.
  
  
  METHODS
  120 clinically diagnosed cases of scabies (>5 years of age and/or >15 kg) were randomized into three treatment groups A, B, C of 40 patients each; receiving either topical 5% permethrin (group A) or oral ivermectin (200 μg/kg/dose) in a single dose (group B) or double dose regimen (group C) repeated at 2 weeks interval. Patients were followed up at 1, 2, and 4 weeks interval. At each visit, cure rate (>50% improvement in lesion count and pruritus and negative microscopy) was assessed and compared.
  
  
  RESULTS
  Cure rate in three treatment groups at the end of 4 weeks was 94.7% (A), 90% (B), 89.7% (C), and thus all three treatment modalities were equally efficacious. However, at 1 week follow up, group A patients reported better improvement in both lesion count and pruritus.
  
  
  CONCLUSIONS
  Both permethrin and ivermectin in both single and two dose regimen are equally efficacious and well tolerated in scabies. However, permethrin has a rapid onset of action.
authors.affiliation: Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, University of Delhi, Delhi, India.
authors.forename: Reena
authors.initials: R
authors.lastname: Sharma
authors.forename: Archana
authors.initials: A
authors.lastname: Singal
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D002648:Child; D019468:Disease Management; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage*; D008297:Male; D026023:Permethrin / Q000008:administration & dosage*; D011446:Prospective Studies; D012532:Scabies / Q000188:drug therapy* / Q000473:pathology*; D055815:Young Adult
chemical_list: D026023:Permethrin; D007559:Ivermectin