Comparative Effectiveness of Ivermectin and Permethrin in the Treatment of Scabies Diagnosed in the Emergency Department

Objective: We aimed to compare the effectiveness of systemic oral ivermectin and topical permethrin in the treatment of scabies in emergency departments (ED).
Material and Methods: In this prospective, observational, cross-sectional single-center study, patients who presented to the ED with pruritus and were diagnosed with scabies received either topical permethrin or oral ivermectin, based on the clinician’s preference. After treatment, the patients were scheduled for follow-up examinations one and two weeks later to assess the treatment effectiveness.
Results: A total of 177 patients were included in this study, comprising 106 (59.9%) men and 71 (40.1%) women. No statistically significant difference was found in terms of treatment effectiveness between patients using topical permethrin and those using oral ivermectin at the 7- and 14-day follow-ups (p=0.656 and p=0.604, respectively). After two courses of treatment, 42 (23.7%) patients were considered to have an ineffective response and received alternative treatment.
Conclusion: Scabies are managed and treated by dermatologists and emergency medicine physicians in Türkiye. The effectiveness of topical permethrin and oral ivermectin, which are commonly used as first-line treatments for scabies, appears to be similar. The treatment efficacies of both drugs were lower than expected. Improvements in patient adherence and medication access, family member contributions to treatment, and patient education regarding home hygiene can improve treatment outcomes.

Keywords: Scabies, itching, sarcoptes scabiei, pruritus