Comparison of Topical Ivermectin and Oral Ivermectin in the Treatment of Human Scabies: A Randomized Controlled Trial

Objective: To compare the topical and oral ivermectin (IVM) in the management of scabies. Materials and Methods: An open-labeled parallel randomized trial was conducted among patients of scabies. Group A (n = 51) received two applications of 0.5% topical IVM cream 1 week apart, while Groups B (n = 50) received single dose of oral IVM (200 µg/kg body weight. The scabies severity and pruritus severity on the Visual Analog Scale (VAS) were compared at baseline and at the end of the 1st, 2nd, and 4th weeks. Mann–Whitney U-test and Wilcoxon Signed-Rank test were used for statistical analysis. Results: Significant improvement in scabies severity was seen at the 1st and 2nd follow-up in both groups (P < 0.001). The cure rate was 2%, 96.1%, and 100% in Group A, while 68%, 98%, and 100% in Group B at each follow-up, respectively. Group B had significantly better improvement than Group A at the 1st follow-up (P < 0.001). Highly significant improvement in pruritus was seen at each visit in both groups (P < 0.001) with no difference between the groups (P > 0.05). Adverse events were reported nine and 12 times in Groups A and B, respectively. Conclusion: Two applications of 0.5% topical IVM cream and single dose of oral IVM are equally efficacious and safe for the treatment of scabies at the end of the 2nd and 4th weeks.