Treatment of scabies with oral ivermectin in 15 infants: a retrospective study on tolerance and efficacy

BackgroundThe incidence of scabies is increasing in Europe, and it often affects children and infants. Although numerous topical treatments have been approved for treatment of scabies in adults, they are often poorly tolerated in infants. One treatment, ivermectin, remains off label for infants weighing <15kg. ObjectivesTo report our experience on the safety and efficacy of oral ivermectin in refractory scabies in infants. MethodsA retrospective study was performed in the dermatology and paediatrics departments of Rouen University Hospital between January 2009 and October 2012. Infants diagnosed with scabies were identified, and the data for those fulfilling the inclusion criteria were analysed. ResultsOf 219 infants identified, 15 had received oral ivermectin and had been followed up for at least 3months. All 15 patients were given two doses of ivermectin, 200gkg(-1), at baseline and 14days later. Of 14 patients contacted 1month after treatment, 12 had achieved healing. The other two were treated with ivermectin or benzyl benzoate; both healed. Overall, 3months after the first ivermectin treatment, 13/14 patients had healed and only one had active disease. ConclusionsIvermectin is generally well tolerated in infants. The 80% rate of healing observed in infants who had failed to respond to at least two other topical treatments suggests that ivermectin could be considered for treatment of infants with recalcitrant or relapsing scabies.