Ivermectin for Sarcoptes scabiei hyperinfestation

Int J Infect Dis. Jan-Mar 1998;2(3):152-4. doi: 10.1016/s1201-9712(98)90118-7.


Objectives: Crusted (Norwegian) scabies is an unusual variant of scabies caused by hyperinfestation with Sarcoptes scabiei. It has high morbidity, and secondary bacterial skin sepsis may result in life-threatening bacteremia. An open label study of oral ivermectin was carried out in patients with crusted scabies refractory to topical therapy.

Methods: Patients with refractory crusted scabies were prescribed oral ivermectin, one to three doses of 200 mg/kg at 14-day intervals, combined with topical scabicide and keratolytic therapy.

Results: Of the 20 patients who received ivermectin, 8 had a complete initial clinical response, a partial response was achieved in 9, and minimal improvement occurred in 3. Three doses of ivermectin were curative for 8 of 10 cases, but recurrence of scabies from presumed reinfestation occurred in at least half of these.

Conclusion: The authors conclude that ivermectin is effective for crusted scabies; however, multiple doses may be required to achieve a cure, and recurrence 6 or more weeks after completing treatment is common.

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Animals
  • Antiparasitic Agents / administration & dosage
  • Antiparasitic Agents / therapeutic use*
  • Australia
  • Female
  • Humans
  • Ivermectin / administration & dosage
  • Ivermectin / therapeutic use*
  • Male
  • Middle Aged
  • Native Hawaiian or Other Pacific Islander
  • Northern Territory
  • Scabies / drug therapy*
  • Treatment Outcome


  • Antiparasitic Agents
  • Ivermectin