Comparative study of Efficacy and Safety of Oral Ivermectin, Topical Permethrin and Benzyl Benzoate in the Treatment of Scabies at a Tertiary Care Hospital

Sarcoptes Scabiei a blind insect and is highly parasitic as well handicapped by its parasitism, not able to survive outside the human body. Even though despite all of its limitations and handicaps it survives and thrives may be the reason behind is failure on the part of human beings to understand its biology. It is a common disease that dominates the pattern of skin infection in developing nations, wherein it causes distress and discomfort to children‟s and families. It is a common dermatological problem which can be managed effectively by the physicians who possess an appropriate knowledge of the available drugs and properly instruct the patients. The basic need is willing physician and equally a cooperative patient for successful treatment of this disease. In present study, though the outcome was equivocal at 6th weeks of post treatment, it was Topical Permethrin who scored over Benzyl Benzoate and Ivermectin in providing statistically significant higher cure rates at the end of 1st week, 2nd week, 4th week of therapy. This element may have an important bearing in a contagious disease like Scabies where chain or risk of transmission of disease can be curbed at a relatively early stage. Present study result suggest that topical application of Permethrin and Benzyl Benzoate were relatively equally efficacious in comparison to oral Ivermectin and therefore suitable to be considered as treatment of choice. However Oral Ivermectin is well tolerated and is also non irritant to the skin with no central nervous system side effects as it do not cross blood brain barrier, hence it can be considered useful in those patients in whom topical treatment is potentially irritant and not well tolerated. It has few outweighing advantages over the topical permethrin. It is cost-effective and as treatment can be given to masses with better compliance with or without supervision in complicated cases wherein topical Scabicidal drugs fail, where Permethrin resistance is seen or where topical agents leads to non compliance. • Topical permethrin shown greater efficacy and rapid improvement from initiation till completion of therapy than other drugs such as benzyl benzoate and ivermectin in the treatment scabies. Therefore permethrin is suitable to be considered as treatment of choice for scabies. • Only two patients had reported mild superficial burning and increase in pruritus with benzyl benzoate as compared with permethrin group. Topical permethrin, oral ivermectin were found to be significantly safer in scabies patients than benzyl benzoate. The study suggests that Topical permethrin and oral ivermectin are considered safe in the management of scabies in comparison to benzyl benzoate. • Scabies control requires community education and their involvement apart from access to primary care and attention for living condition and environmental factors also apart from medication