Comparison of oral ivermectin vs. lindane lotion 1% for the treatment of scabies

BACKGROUND: Scabies is a common parasitic infestation that is an important public-health problem in many resource-poor regions. It is commonly treated with the insecticides ivermectin and permethrin. AIM: To compare the efficacy and safety of oral ivermectin vs. lindane lotion 1% for the treatment of scabies. METHODS: In total, 148 patients with scabies were enrolled, and were randomized into two groups: the first group received a single dose of oral ivermectin 200 μg/kg body weight, and the second group were treated with two applications of topical lindane lotion 1%, with a 1-week interval between applications. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. RESULTS: A single dose of ivermectin provided a cure rate of 60.8% at the 2-week follow-up, which increased to 89.1% at the 4-week follow-up. after crossing over to the lindane lotion 1% group. Treatment with two applications of lindane lotion 1%, with a 1-week interval between them, was effective in 47.2% of patients at the 2-week follow-up, which increased to 72.9% at the 4-week follow-up after this treatment was repeated. CONCLUSIONS: A single dose of ivermectin was as effective as two applications of lindane lotion 1% at the 2-week follow-up. After repeat treatment, ivermectin was superior to lindane lotion 1% at the 4-week follow up. The delay in clinical response with ivermectin suggests that it may not be effective against all the stages in the life cycle of the parasite.