COMPARATIVE EFFICACY AND SAFETY OF TOPICAL 1% IVERMECTIN AND 5% PERMETHRIN CREAMS IN PEDIATRIC PATIENTS WITH UNCOMPLICATED SCABIES: A PROSPECTIVE CLINICAL STUDY
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Keywords
Scabies, sarcoptes scabiei, pediatric dermatology, permethrin, ivermectin
Abstract
Introduction: Scabies is a highly contagious skin condition caused by Sarcoptes scabiei var. hominis. Pediatric patients are particularly vulnerable due to close interpersonal interactions, necessitating effective and well-tolerated treatment options. Although topical 5% Permethrin is widely used, topical 1% Ivermectin cream is emerging as an alternative with potential advantages in efficacy and tolerability.
Methods and Material: A prospective, comparative clinical trial was conducted on 140 pediatric patients of age group 5 to 18 years diagnosed with uncomplicated scabies in a tertiary care hospital. Participants were randomly assigned to receive either topical 1% Ivermectin or topical 5% Permethrin cream, applied once at night and repeated after seven days.
Treatment efficacy was assessed at weeks 1, 2, and 4 based on pruritus severity (VAS scale), lesion count, treatment response, and adverse effects. Chi-square tests, t-tests, and Fischer's exact test were used to compare treatment outcomes.
Results: By week 4, the Ivermectin group demonstrated significantly superior improvement in pruritus severity (VAS score: 2.1 ± 0.9 vs. 2.8 ± 1.0, p < 0.001) and lesion count reduction. A significantly higher percentage of patients in the Ivermectin group achieved a good response (>75% improvement) compared to the Permethrin group (45.71% vs. 24.28%, p = 0.049). Adverse effects were less frequent in the Ivermectin group (17.1%) compared to the Permethrin group (41.4%).
Conclusions: Topical 1% Ivermectin cream demonstrated greater efficacy, faster symptom relief, and a better safety profile compared to 5% Permethrin in pediatric scabies. These findings suggest that Ivermectin may be a preferred first-line treatment, especially in children. Future studies with larger cohorts are essential to confirm these results and assess resistance patterns.
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Dr. Aman
Junior Resident Department of dermatology, Rajshree medical research institute, bareilly, India
Dr. Sapna Goyal
Professor & Head, Department of dermatology, Rajshree medical research institute, bareilly, India
Dr. Ajitesh P Varshney
Associate Professor, Department of dermatology, Rajshree medical research institute, bareilly, India
Dr. Vijay Gupta
Professor Department of dermatology, Rajshree medical research institute, bareilly, India
Dr Amrisha Ambashta
Junior Resident Department of dermatology, Rajshree medical research institute, bareilly, India
Dr Somula Sushma Reddy
Junior Resident Department of dermatology, Rajshree medical research institute, bareilly, India