Study of efficacy and cost effectiveness of topical permethrin, benzyl benzoate and oral ivermectin in the treatment of scabies

Abstract

Background: Scabies is an ectoparasitic infestation caused by the mite Sarcoptes scabiei var hominis that occurs due to direct skin to skin contact.It is a common public health problem that affects humans regardless of age, gender and social class.An ideal scabicide should be effective against both adult and egg of the mite, easily applicable, acceptable, nontoxic, and economical. It should be safe to use in all ages. Objectives: To compare the therapeutic efficacy and cost effectiveness of topical 5% permethrin, 25% benzyl benzoate and oral ivermectin (200mcg/kg/dose) in the treatment of scabies. Materials and Methods: A total of 90 patients with scabies attending the dermatology outpatient at the Department Of Dermatology, Venereology and Leprosy, Adichunchanagiri Hospital and Research Centre, B.G. Nagara, were randomly divided into three treatment groups A, B and C with 30 patients in each group. Group A patients received 5% permethrin cream which was made to remain in contact with the skin for at least 8 hours. This was repeated after 7 days. Group B patients received 25% benzyl benzoate lotion which was made to remain in contact with the skin for at least 8 hours. This was done for three consecutive nights. Group C patients received oral ivermectin in a single dose of 200mcg/kg body weight taken with meals and it was repeated after 10 days. All patients were followed up at the end of first, second and third week to assess clinical grading score and pruritus grading score by visual analogue scale. The cost effectiveness was calculated on basis of total expenditure on medicine at the end of the third week and cure rate of the three groups were compared on the basis of amount needed to treat one case successfully. Results: At the end of third week, complete clinical cure was seen in 28 (93.3%) patients in group A, 13 (43.3%) patients in group B and 22 (73.3%) of patients in group C. Permethrin was more efficacious than benzyl benzoate and ivermect