Abstract :
Background Ivermectin is structurally similar to the macrolide antibiotics, but does not have antibacterial activity. It is, however, active against number of ecto- and endoparasites. It has been extensively employed in veterinary medicine, and in humans it is used to treat filarial diseases, principally onchocerciasis. Objective A clinical trail was conducted for the first time in Pakistan to determine the efficacy of oral ivermectin in patients with scabies and its comparison with the most effective standard treatment available until now i.e. permethrin applied locally. Patients and methods This non randomized, open-label comparison study was conducted in department of dermatology, Pakistan Institute of Medical Sciences, Islamabad, from January, 2007 to March, 2007. 30 patients, 12 years of age or older were enrolled in the study. Diagnosis was made on the basis of clinical features, including history and clinical examination with typical lesions and sites of involvement. 15 patients received orally administered ivermectin, two doses of 200 μg/kg body weight separated by one week. Remaining 15 patients received local treatment with permethrin 5%, according to the standard method, in which it is applied for 12 hours and was repeated after one week. Pretreatment complete physical examination was done along with necessary laboratory investigations in all cases. They were repeated after 2 weeks at the end of treatment to note any abnormality developing. Groups were almost matched in terms of age, sex and weight. The efficacy was evaluated by the relief of symptoms and disappearance of the lesions. Results All patients completed therapy without any complication. Patients recovered completely with relief of symptoms and complete healing of skin lesions. The cure rate was 100% in both groups, at the end of treatment period. Conclusion Ivermectin seems to be a safe and effective alternative to permethrin. The striking advantage of ivermectin being its benefit of oral administration and low cost
