A comparative study of oral ivermectin and topical permethrin cream in the treatment of scabies

J Am Acad Dermatol. 2000 Feb;42(2 Pt 1):236-40. doi: 10.1016/S0190-9622(00)90131-2.


Background: The conventional antiscabietics have poor compliance. Ivermectin, an oral antiparasitic drug, has been shown to be an effective scabicide and could be a useful substitute.

Objective: This study compares the efficacy of oral ivermectin with topical permethrin cream in the treatment of scabies.

Methods: Eighty-five consecutive patients were randomized into 2 groups. Forty patients and their family contacts received 200 microg/kg body weight of ivermectin, and another 45 patients and their family contacts received a single overnight topical application of 5% permethrin cream. Patients were followed up at intervals of 1, 2, 4, and 8 weeks.

Results: A single dose of ivermectin provided a cure rate of 70%, which increased to 95% with 2 doses at a 2-week interval. A single application of permethrin was effective in 97.8% of patients. One (2.2%) patient responded to 2 applications at a 2-week interval. Permethrin-treated patients recovered earlier.

Conclusion: A single application of permethrin is superior to a single dose of ivermectin. Two doses of ivermectin is as effective as a single application of permethrin. The temporal dissociation in clinical response suggests that ivermectin may not be effective against all the stages in the life cycle of the parasite.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Administration, Topical
  • Adolescent
  • Adult
  • Child
  • Family Health
  • Female
  • Humans
  • Insecticides / administration & dosage*
  • Insecticides / pharmacology
  • Ivermectin / administration & dosage*
  • Ivermectin / pharmacology
  • Male
  • Permethrin
  • Pyrethrins / administration & dosage*
  • Pyrethrins / pharmacology
  • Scabies / drug therapy*
  • Scabies / pathology
  • Treatment Outcome


  • Insecticides
  • Pyrethrins
  • Permethrin
  • Ivermectin