Topical ivermectin versus crotamiton cream 10% for the treatment of scabies

Abstract

Scabies, known colloquially as the 7-year itch, is a contagious skin infection that occurs among humans and other animals. The treatment of choice is still controversial. The aim of this study was to compare the efficacy and safety of topical ivermectin vs. crotamiton cream 10% for the treatment of scabies. In total, 340 patients with scabies were enrolled, and randomized into two groups. The first group received 1% ivermectin applied topically to the affected skin. The dose employed was 400 μg/kg, repeated once the following week, and the second group received crotamiton 10% cream and were told to apply this twice daily for five consecutive days. Treatment was evaluated at intervals of two and four weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Two applications of topical ivermectin provided a cure rate of 64.7% at the 2-week follow-up, which increased to 82.3% at the 4-week follow-up after repeating the treatment. Treatment with single applications of crotamiton cream 10% was effective in 41.2% of patients at the 2-week follow-up, which increased to 64.7% at the 4-week follow-up after this treatment was repeated. Ivermectin was quite safe in our cases. Two applications of ivermectin were as effective as single applications of crotamiton 10% cream at the 2-week follow-up. After repeating the treatment, ivermectin was superior to crotamiton cream 10% at the 4-week follow-up.

Clinical Studies on the Efficacy of Different Topical Drugs with Ivermectin Injection in the Treatment of Egyptian Water Buffalo Calves Infested with Psoroptes Spp. Mites

“…Topical ivermectin is more effective than crotamiton 10% cream but regarding side effects, crotamiton was found to be significantly safer than ivermectin (P < 0.05). Ivermectin continued to decrease both the lesions, and the degree of pruritus as compared to crotamiton and this difference was statistically significant (P < 0.05) (Goldust et al, 2014).…”

Treatment, prevention and public health management of impetigo, scabies, crusted scabies and fungal skin infections in endemic populations: a systematic review

“…30%, P < 0.05) whilst cure at 4 weeks was universal for all three agents . Topical permethrin and topical ivermectin were superior to topical crotamiton at 4 weeks follow‐up. Topical permethrin was superior to Tenutex emulsion .…”

“…Permethrin is superior to lindane ( 1A ) , topical crotamiton ( 2C ) or Tenutex emulsion (disulphiram and benzyl benzoate [BB]) in those >4 years ( 2C ) . Topical ivermectin is superior to topical crotamiton in those >2 years ( 2C ) . Very low‐quality evidence from one study shows that topical BB or topical permethrin is safe in pregnant women ( 2C ) .…”

“…Directed anti-parasitic therapy. Topical treatment vs. topical treatment-Seven studies compared topical antiparasitic agents for scabies [32][33][34][35][36][37][38], with low to moderate quality evidence for either topical permethrin or topical ivermectin (2B) [32,33]. Permethrin is superior to lindane (1A) [34], topical crotamiton (2C) [35] or Tenutex emulsion (disulphiram and benzyl benzoate [BB]) in those >4 years (2C) [36].…”

“…When topical ivermectin 1% and topical permethrin 5% were compared with oral ivermectin, clinical response at 1 week was superior with either topical treatment (69% and 75% vs. 30%, P < 0.05) whilst cure at 4 weeks was universal for all three agents [32]. Topical permethrin [35] and topical ivermectin [37] were superior to topical crotamiton at 4 weeks follow-up. Topical permethrin was superior to Tenutex emulsion [36].…”