Oral ivermectin for the treatment and prophylaxis of scabies in prison

Introduction: Oral ivermectin has been widely used to treat various human diseases, such as filariasis, myiasis, larva migrans, strongyloidiasis and scabies (both the common and crusted forms). However, there are only a small number of papers on the effects of this drug for the control of scabies in infested environments. The current study shows the results obtained with the collective treatment of inmates of a public jail. Materials and methods: A total of 123 inmates living in a restricted and contaminated environment were evaluated clinically by experienced dermatologists for the assessment of the degree of infestation by Sarcoptes scabiei, and were then treated with oral ivermectin (200-300 mg/kg single dose repeated after 7 days). Both clothing and environment were disinfected. Patients were re-evaluated after 15 days. Results: In all, 78% of the inmates were infected upon initial evaluation. Re-evaluation 15 days after repeat treatment revealed a cure rate of 91.05%. Prophylaxis was also highly effective, where 93.2% of the non-infected inmates and virtually all the house staff remained disease-free throughout the study period. Two of the 29 inmates (6.8%) who showed no apparent lesions upon initial examination were found to be infected upon re-evaluation. These patients responded well to a third dose of ivermectin. Conclusions: Oral ivermectin at a dose of 300 mg/kg single dose repeated after 7 days proved effective for the treatment and prophylaxis of scabies in an infected institutional environment.