To study cost effectiveness of topical permethrin versus oral ivermectin in patients of uncomplicated scabies
Keywords:
Scabies, Permethrin, IvermectinAbstract
Background: The objective of this study was to compare the cost and effectiveness of topical permethrin and oral ivermectin in the treatment of uncomplicated scabies.
Methods: This was an open label randomized comparative study conducted in 210 patients, randomly allocated to two groups. First group received permethrin 5% cream as single application, second group received tablet ivermectin 200mcg/kg as single dose. All the patients received antihistaminic for pruritus. The patients were followed up at intervals of one, two, three and four weeks. If there were no signs of cure, the same intervention was repeated at each follow up. The cost effectiveness was calculated on the basis of total expenditure incurred on therapy.
Results: At the end of first week cure rate was 74.8% in permethrin group, 30% in oral ivermectin group. At the end of second week cure rate was 99% in permethrin group, 60% in oral ivermectin group. At the end of third week 100% cure rate was observed in permethrin while 99% in oral ivermectin group. The total cost of treatment shows that cost of tab. ivermectin was less compared to permethrin 5% but the cost to relieve itching and cost of transport was higher than permethrin 5%.
Conclusions: Topical permethrin is more cost effective than oral ivermectin in treatment of uncomplicated scabies.
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References
Scheinfeld N. Controlling scabies in institutional settings: a review of medications, treatment models, and implementation. Am J Clin Dermatol 2004;5:31-7.
Taplin D, Meinking TL. Pyrethrins and pyrethroids in dermatology. Arch Dermatol 1990b;126:213-21.
Tracy WJ, Webster LT. Drugs used in the chemotherapy of helminthiasis. In, Hardman JG, Limbird LE. Goodman Gilman’s The pharmacological basis of medical therapeutics, 11th edition. New York, McGraw Hill. 2007;1009-26.
Campbell WC. Ivermectin, an antiparasitic agent. Med Res Rev 1993;13:61–79.
Glaziou P, Cartel JL, Alzieu P, Briot C, Moulia-Pelat JP, Martin PM. Comparison of ivermectin and benzyl benzoate for treatment of scabies. Trop Med Parasitol 1993;44:331–2.
Macotela-Ruíz E, Peña-González G. The treatment of scabies with oral ivermectin. Gac Med Mex 1993;129:201-5.
Chouela EN, Abeldaño AM, Pellerano G, La Forgia M, Papale RM, Garsd A, et al. Equivalent therapeutic efficacy and safety of ivermectin and lindane in the Treatment of Human Scabies. Arch Dermatol 1999;135:651-5.
Usha V, Gopalakrishnan Nair TV. A comparative study of oral ivermectin and topical permethrin cream in the treatment of scabies. J Am Acad Dermatol 2000;42:236-40.
Heitjan DF, Moskowitz AJ, and Whang W. Bayesian estimation of cost- effectiveness ratios from clinical trials. Health Econ. 1999;8:191-201.
Elgart ML. Cost-benefit analysis of ivermectin, permethrin and benzyl benzoate in the management of infantile and childhood scabies. Expert Opin Pharmacother. Sep 2003;4(9):1521-4.
Bachewar NP, Thawani VR, Mali SN, Gharpure KJ, Shingade VP, Dakhale GN. Comparison of safety, efficacy, and cost effectiveness of benzyl benzoate, permethrin, and ivermectin in patients of scabies. Indian J Pharmacol 2009;41:9-14.
Feldmeier H Epidermal parasitic skin diseases: a neglected category of poverty-associated plagues. Bull World Health Organ 2009;87:152–159.
Simons FE, Murray HE, Simons KJ Quantitation of H1 antagonists in skin and serum. J Allergy Clin Immunol 1995;95(3):759-64.
Ly F, Caumes E, Ndaw CA, Ndiaye B, Mahé A. Ivermectin versus benzyl benzoate applied once or twice to treat human scabies in Dakar, Senegal: a randomized controlled trial. Bull World Health Organ 2009;87:424-30.