Template:Scabies treatment: Difference between revisions

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(Add pediatric AntibioticDose entries for Permethrin and Ivermectin)
 
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===General Care===
*Wash all linens/clothes in hot water or bag bulky items and keep sealed for 2wks
*Pruritus may continue for weeks despite successful elimination of infestation
**Consider steroids for symptom relief
===Adults===
===Adults===
*'''[[Permethrin]]''' 5% cream for all family members<ref>Strong M. Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev. 2007;(3):CD000320</ref>
*'''{{AntibioticDose|disease=Scabies|drug=Permethrin|dose=5% cream neck down leave 8-12hrs repeat 1-2wks|context=First line adults|population=Adult}}''' for all family members<ref>Strong M. Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev. 2007;(3):CD000320</ref>
**Apply from neck down
**Apply from neck down
**Leave on for 8-12hr before washing off
**Leave on for 8-12hr before washing off
**Has 95-98% success rate, may reapply in 1-2wks if incomplete effect
**Has 95-98% success rate, may reapply in 1-2wks if incomplete effect
*'''[[Ivermectin]]''' 200 mcg/kg may be necessary for severe infection
*'''{{AntibioticDose|disease=Scabies|drug=Ivermectin|dose=200mcg/kg PO repeat in 2wks|context=Severe infection|population=Adult}}'''
**Also viable option in adolescent or adult with insecure social situation
**Also viable option in adolescent or adult with insecure social situation
**Success rate 70%, increases if give repeat dose 2wks after
**Success rate 70%, increases if give repeat dose 2wks after
**Contraindicated in lactating women and children < 15kg
**Contraindicated in lactating women and children < 15kg


===Infants===
===Pediatric===
*'''[[Permethrin]]''' 5% is FDA approved for > 2 months of age although still recommended for neonatal scabies<ref>Subramaniam S. Rutman MS. Wnger JK. A papulopustular, vesicular, crusted rash in a 4-week old neonate. Pediatric Emergency Care. 2013;29:1210-1212</ref>
*{{AntibioticDose|disease=Scabies|drug=Permethrin|dose=5% cream, apply head to toe (avoid mucous membranes), leave 8-12hrs, wash off; repeat in 1-2 weeks|context=Pediatric (>2 months)|population=Pediatric}}
**May require application head to toe (avoid mucus membranes)
**FDA approved for >2 months of age; also recommended for neonatal scabies
**Leave on for 8-12 hours, then wash off
*{{AntibioticDose|disease=Scabies|drug=Ivermectin|dose=200mcg/kg PO, repeat in 2 weeks; only for children >15kg|context=Pediatric Severe (>15kg)|population=Pediatric}}
 
===Avoid===
*'''[[Lindane]]''' - effective treatment but associated with potential for toxic manifestations (seizures, neurotoxicity)
**Reserved for refractory cases

Latest revision as of 13:11, 20 March 2026

Adults

  • Permethrin 5% cream neck down leave 8-12hrs repeat 1-2wks for all family members[1]
    • Apply from neck down
    • Leave on for 8-12hr before washing off
    • Has 95-98% success rate, may reapply in 1-2wks if incomplete effect
  • Ivermectin 200mcg/kg PO repeat in 2wks
    • Also viable option in adolescent or adult with insecure social situation
    • Success rate 70%, increases if give repeat dose 2wks after
    • Contraindicated in lactating women and children < 15kg

Pediatric

  • Permethrin 5% cream, apply head to toe (avoid mucous membranes), leave 8-12hrs, wash off; repeat in 1-2 weeks
    • FDA approved for >2 months of age; also recommended for neonatal scabies
  • Ivermectin 200mcg/kg PO, repeat in 2 weeks; only for children >15kg
  1. ↑ Strong M. Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev. 2007;(3):CD000320
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