Source:
Investigators from the Medical University of Vienna, Austria, and Paracelsus Medical University, Salzburg, Austria, conducted a retrospective study to assess the effectiveness of different permethrin 5% treatment regimens in eradicating scabies in young children. Study participants were patients <4 years old seen in the department of dermatology at the Medical University of Vienna between 2017 and 2020 with confirmed scabies. The medical records of study children were reviewed and demographic, clinical, treatment, and outcome information abstracted. Patients were treated with 4 different permethrin 5% regimens: permethrin 5% cream on day 1 and 8, treatment on days 1, 8, and 15, treatment on days 1, 8, and 15 with additional treatment on hands and feet on days 2,3 4, 9, 10, and 11 (intensified regimen), and permethrin 5% with additional medications (alternative regimen). Children were re-examined 2-4 weeks after beginning treatment, and eradication of scabies was defined as disappearance of lesions, absence of new lesions, and lack of dermatoscopically visible mites. Eradication rates in children treated with the intensified regimen were compared individually to rates in patients treated with other permethrin regimens with chi-square tests. Subgroup analyses were conducted and limited to children who failed treatment with permethrin-based therapies prior to being seen in the dermatology department. Logistic regression was used to compare eradication rates in those treated with the intensified regimen to all other regimens combined, after adjusting for sex and previous permethrin-based treatments.
Data were analyzed on 85 cases of scabies. The mean age of participants was 1.5 ±1.1 years, and there were 49 patients (57.6%) who failed treatment with permethrin-based treatment prior to being seen. Overall, 25 children (29.4%) were treated with permethrin 5% on days 1 and 8; 26 (30.6%) were treated on days 1, 8 15; 34 (40.0%) received the intensified regimen; and 25 (29.4%) received alternative regimens. Among those treated with the intensified regimen, scabies was eradicated in 73.5%, which was significantly better (P = 0.022) than the eradication rate in children treated with permethrin 5% on days 1 and 8. There was no significant difference in eradication rates in children treated with the intensified regimen or those treated on day 1, 8, and 15 (eradication rate, 53.8%) or alternative regimens (60.0%). After adjusting for sex and previous permethrin treatment, the intensified regimen was associated with a significantly increased likelihood of scabies eradication (OR, 2.50; 95% CI, 1.03, 6.06). Among those who had failed previous treatment with permethrin, eradication rates on re-treatment were 71.4%, 30.0%, 55.6%, and 53.8%, respectively, with the intensified regimen, permethrin on days 1 and 8, treatment on days 1, 8, and 15, and alternative regimens.
The authors conclude that the intensified permethrin regimen was more effective than other permethrin regimens in curing scabies in young children.
Dr Doolittle has...
Comments