title: The Treatment of Scabies.
abstract: BACKGROUND
  Scabies is a contagious infestation transmitted by skin-to-skin contact and sometimes by contact with contaminated material. The scabies mite burrows into the skin, producing a papular rash and severe itch at typical sites of predilection.
  
  
  METHODS
  We systematically reviewed the literature to compare the efficacy of various anti-scabies agents, including a calculation of relative risks and confidence intervals.
  
  
  RESULTS
  A literature search yielded 596 initial hits; after screening in accor-dance with the defined inclusion and exclusion criteria, 16 studies were selected for this review. Among topical treatments for scabies, permethrin was equally effective or more effective than crotamiton or benzyl benzoate. In a comparison of topical versus systemic treatment, topical permethrin and systemic ivermectin did not differ substantially in efficacy (7 comparative studies revealed no difference; one revealed a difference in favor of permethrin). Comparative trials of topical benzyl benzoate versus systemic ivermectin yielded inconsistent findings. Single and double administrations of ivermectin were similarly effective. In trials involving entire populations with a high prevalence of scabies, systemic ivermectin was found to be superior to topical permethrin.
  
  
  CONCLUSIONS
  There are hardly any differences in efficacy between the available treatments for scabies. Single administrations of permethrin 5%, crotamiton 10%, and systemic ivermectin are all comparably effective. There are differences in the frequeny and ease of application as well as when eradicating scabies in populations with a high prevalence.
authors.affiliation: Division of Evidence-Based Medicine (dEBM), Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin; Department of Dermatology and Venereology, University Hospital Halle.
authors.forename: Corinna
authors.initials: C
authors.lastname: Dressler
authors.forename: Stefanie
authors.initials: S
authors.lastname: Rosumeck
authors.forename: Cord
authors.initials: C
authors.lastname: Sunderkötter
authors.forename: Ricardo Niklas
authors.initials: RN
authors.lastname: Werner
authors.forename: Alexander
authors.initials: A
authors.lastname: Nast
mesh_terms: D000287:Administration, Topical; D000977:Antiparasitic Agents / Q000627:therapeutic use*; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use; D026023:Permethrin / Q000627:therapeutic use; D012532:Scabies / Q000188:drug therapy*
chemical_list: D000977:Antiparasitic Agents; D026023:Permethrin; D007559:Ivermectin