What is the best approach for treating classical scabies?
For classical scabies, the authors recommend two applications of topical permethrin 5% — one on day 1 and one between day 8 and day 15. The drug should be applied in the evening and left on overnight. Two doses of oral ivermectin (200 µg/kg/dose), taken with food — one on day 1 and one between day 8 and day 15 is an alternative strategy.
When should ivermectin be used to treat scabies?
Ivermectin should be used in combination with topical permethrin 5% to treat crusted scabies. Ivermectin can also be used as a single dose to treat close contacts, or as an alternative to permethrin treatment in patients with classical scabies. Ivermectin is not approved for this indication by the Food and Drug Administration.
How should pregnant women with scabies be treated?
Topical 5% permethrin can be administered to pregnant women. It is recommended that ivermectin and lindane not be used during pregnancy.
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NEJM.org
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