Comparison of safety and cost-effectiveness of topical 5% permethrin and topical 1% ivermectin in patients of uncomplicated scabies

Abstract

Background: Scabies is an infestation of the skin by the mite Sarcoptes scabiei that causes a pruritic skin eruption. Scabies is a relatively common infestation that can affect individuals of any age and socioeconomic status. The worldwide prevalence is estimated to be 100 million people, with wide variation in prevalence among individual geographic regions.Worldwide, an estimated 300 million cases occur annually.The burden of the disease is highest in developing countries where the disease is endemic. Many studies were conducted on scabies using different therapies to compare the efficacy. However, only some studies were conducted by comparing the safety and cost-effectiveness. Our country is a developing country. Hence, cost is an essential factor in the individual and public health sector. Aims and Objectives: This study aims to provide better and improved treatment options for scabies based on efficacy, safety, and cost-effectiveness profile with objective to compare the efficacy, cost-effectiveness, and safety profile of 5% permethrin and 1% ivermectin in uncomplicated scabies patients. Materials and Methods: This was a randomized, prospective, open-label, comparative, parallel study. After taking Institutional Ethics Committee permission, the study was conducted from May 2019 to June 2019, on 95 patients who came to RVMIMS hospital dermatology outpatient department, Laxmakkapally, Mulugu Mandal, Siddipet district in Telangana state, and diagnosed scabies is randomly allocated to two groups. One group received permethrin 5% cream as a single application, and the other group received ivermectin 1% lotion as a single application. Results:A total of 93 patients were enrolled in the study and randomly allocated into two treatment groups, permethrin group having 48 patients and ivermectin group having 45 patients. Conclusion: Although topical 5% permethrin is as effective as topical 1% ivermectin, permethrin is considered as superior drug compared to topical ivermectin regarding safety andcost-effectiveness. There were two dropouts of patients during the study in ivermectin intervention. At the end of the study, we concluded that topical 5% permethrin is safer and cost-effective drug compared to topical 1%ivermectin.