Efficacy and tolerance of oral ivermectin in scabies.

OBJECTIVE: The aim of this open-label study was to investigate the therapeutic effect and adverse reactions of oral ivermectin in scabies patients.
BACKGROUND: There is much confusion over reports of efficacy, adverse reactions and relapses after oral treatment of scabies with ivermectin.
METHODS: Nineteen patients, ten otherwise healthy outpatients with scabies, and nine inpatients with scabies and another skin disease (dermatomyositis, 3; pemphigus, 2; bullous pemphigoid, 1; pyoderma, 1; HIV, 1; Behçet's disease, 1) were treated with an oral dose of 0.2 mg/kg ivermectin (1% water solution) on days 1 and 8. The presence of live mites and ova in the patient's skin was investigated before, during and after the treatment.
RESULTS: None of the 19 patients with scabies had evidence of scabies after the second dose of ivermectin. In seven patients we noted the enhancement of pruritus 24-72 h after the first administration of ivermectin. In three patients the skin manifestation, vesicle-pustular rash increased between the second and the fourth day.
CONCLUSION: The advantages of oral ivermectin treatment in scabies patients are: high therapeutic efficacy against Sarcoptes scabiei, good tolerance and influence of the drug on the whole skin surface and on clinical symptoms. The administration of the drug is easy and quick.