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DRUG INFORMATION ROUNDS

Ivermectin for the Treatment of Resistant Scabies

Surgery/Critical Care Clinical Specialist, University of Texas Medical Branch, Galveston, TX

Frank Romanelli, PharmD BCPS

Assistant Professor, Clinical Specialist in HIV, College of Pharmacy, University of Kentucky, Lexington, KY

Reprints: Aaron M Cook PharmD, Clinical Sciences Building 1-100, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0701, FAX 413/460-4715, E-mail amcook{at}utmb.edu

OBJECTIVE: To assess the clinical literature describing the use of ivermectin in cases of treatment-resistant scabies infestations.

DATA SOURCES: Clinical literature accessed through a MEDLINE search (1966–July 2001) and the Cochrane Database.

DATA SYNTHESIS: A limited number of case reports and case series describes successful intervention with ivermectin use in patients who have failed prior therapy. Ivermectin may serve as a viable alternative therapy as the incidence of resistant scabitic infestations increases.

CONCLUSIONS: Ivermectin appears to be a safe and effective alternative for patients with treatment-resistant scabies. Larger, controlled clinical trials are required before this therapy can be recommended in the general population or as primary therapy.

Key Words: ivermectin, resistance, scabies

Published Online, December 23, 2002. www.theannals.com, DOI