Cost-benefit analysis of ivermectin, permethrin and benzyl benzoate in the management of infantile and childhood scabies.

In the US, 6% sulfur in petrolatum has been the most frequently administered treatment for infantile scabies. It appears to be safe but there is no literature containing a large series of patients on which to base that determination. In the UK, benzyl benzoate is the approved product. Benzyl benzoate is rarely used in the US at the present time. 5% Permethrin is an excellent substitute and has many advantages. It appears to be quite safe in infants, although it is more expensive than other products. It remains present on the skin for several days, therefore protecting against reinfestation. Ivermectin is a systemic drug which is assumed to be safe in infants, although it requires repeated doses and does not protect against reinfestation. In the opinion of the author, 5% permethrin is the best treatment for scabies in infants and young children.