To compare the clinical cure rates of topical 5% permethrin cream and oral ivermectin for classic scabies, focusing on their effectiveness.
Approach:
Key Findings:
Cure rates were 71.8% for ivermectin and 88.5% for permethrin, a difference of -16.7 percentage points.
Among index cases, cure rates were 76.6% for ivermectin and 91.5% for permethrin, a difference of -14.9 percentage points.
At the individual participant level, cure rates were 85.3% for ivermectin and 94.2% for permethrin, a difference of -9.2 percentage points.
Cutaneous adverse events occurred in 9.9% of ivermectin cases and 13.6% of permethrin cases.
Interpretation:
Topical 5% permethrin demonstrated statistical superiority over oral ivermectin for treating classic scabies; however, clinical decision-making should consider factors such as compliance, adherence, and patient condition.
Limitations:
The trial ended prematurely due to resource limitations, resulting in a smaller sample size than planned, which may affect the robustness of the findings.
Findings may not apply to patients with diffuse eczematization or extensive impetiginization.
Conclusion:
Permethrin is more effective than ivermectin for treating classic scabies, but treatment choice should consider various patient-specific factors.
