TOPLINE:<\/strong><\/h2>\nIn a multicentre randomised trial, 5% permethrin cream demonstrated superior efficacy over oral ivermectin in treating classic scabies, achieving higher cure rates at the household level, across all individual index cases and participants.<\/p>\n
METHODOLOGY:<\/strong><\/h2>\n\n- Researchers conducted a multicentre cluster-randomised trial including 1092 individuals from 294 households, which initially involved 16 French paediatric dermatology departments and was later expanded to 28 centres, from 2016 to 2021.<\/li>\n
- Index cases were initially children (weight \u2265 15 kg); however, the study was extended to adults in March 2017. Each index case was associated with a cluster, consisting members of their household.<\/li>\n
- The cluster was randomly assigned in a 1:1 ratio to either receive oral ivermectin 200 \u03bcg\/kg with food (n = 507 from 142 households) or apply 5% permethrin cream from the head to toe overnight on days 0 and 10 (n = 568 from 147 households), with all children weighing below 15 kg receiving permethrin regardless of group assignment.<\/li>\n
- The primary outcome was the cluster-level cure rate at day 28, defined as a complete resolution of clinical signs and symptoms in all household members, including the index cases. Secondary outcomes included clinical cure at an individual level on day 28 for index cases only or all cluster participants and safety.<\/li>\n<\/ul>\n
TAKEAWAY:<\/strong><\/h2>\n\n- Cluster-level cure rates were 71.8% for participants treated with ivermectin vs 88.5% for those treated with permethrin (percentage point difference [PPD], -16.7; 95% CI, -26.3 to -7.1), demonstrating the inferiority of ivermectin to permethrin.<\/li>\n
- Secondary outcomes showed the inferiority of ivermectin to permethrin, with cure rates of 76.6% vs 91.5% for index cases (PPD, -14.9; 95% CI, -23.6 to -6.2) and 85.3% vs 94.2% for all participants (PPD, -9.2; 95% CI, -14.9 to -3.5).<\/li>\n
- Intraclass correlation coefficients were higher for participants treated with permethrin than for those treated with ivermectin across all clusters (0.68; 95% CI, 0.61-0.75 vs 0.46; 95% CI, 0.37-0.56).<\/li>\n
- At least one cutaneous adverse event occurred in 9.9% of ivermectin-treated and 13.6% of permethrin-treated participants at the index level and in 2.2% and 3.3%, respectively, at the cluster level.<\/li>\n<\/ul>\n
IN PRACTICE:<\/strong><\/h2>\n“The results showed the statistical superiority of permethrin,” the authors wrote. “In decision making in clinical practice, however, factors such as potential compliance, adherence, and ease of use, as well as molecular and clinical tolerance or resistance to scabicides and the skin condition of patients, should be considered when prescribing treatment for scabies,” they concluded.<\/p>\n
SOURCE:<\/strong><\/h2>\nThis study was led by Franck Boralevi, Department of Paediatric Dermatology, H\u00f4pital des Enfants, Groupe Hospitalier Pellegrin, Bordeaux, France. It was published online on January 06, 2026, in BMJ<\/em>.<\/p>\nLIMITATIONS:<\/strong><\/h2>\nThe results could only be generalised to patients without diffuse eczematisation or extensive impetiginisation. Differences in the body surface area between the groups could have affected adherence to permethrin application. Treatment effectiveness might vary due to potential permethrin resistance in certain countries. Some participants self-reported cure assessment on day 28 rather than attending consultation, and data were largely missing for follow-up at day 56. Although recommended, the treatment of out-of-household contacts was not supervised, and no patient information leaflets were provided. This study did not account for social health determinants or standardise textile decontamination procedures.<\/p>\n
DISCLOSURES:<\/strong><\/h2>\nThis study was funded by the French Ministry of Health through Programme Hospitalier de Recherche Clinique and the French Society of Dermatology. Two authors reported serving as investigators for a phase 2 moxidectin Medicines Development for Global Health trial. Full disclosures are noted in the original article.<\/p>\n
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.<\/em><\/p>\n<\/div>\n<\/div>\n
\n
<<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"
TOPLINE: In a multicentre randomised trial, 5% permethrin cream demonstrated superior efficacy over oral ivermectin in treating classic scabies, achieving higher cure rates at the household level, across all individual index cases and participants. METHODOLOGY: Researchers conducted a multicentre cluster-randomised trial including 1092 individuals from 294 households, which initially involved 16 French paediatric dermatology departments […]<\/p>\n","protected":false},"author":1,"featured_media":1730,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_daextam_enable_autolinks":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[2],"tags":[],"class_list":["post-1729","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/diyhaven858.wasmer.app\/wp-content\/uploads\/2026\/01\/gty-260109-baby-with-rash-800x450.jpg","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts\/1729","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/comments?post=1729"}],"version-history":[{"count":0,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts\/1729\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/media\/1730"}],"wp:attachment":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/media?parent=1729"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/categories?post=1729"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/tags?post=1729"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
- \n
- Researchers conducted a multicentre cluster-randomised trial including 1092 individuals from 294 households, which initially involved 16 French paediatric dermatology departments and was later expanded to 28 centres, from 2016 to 2021.<\/li>\n
- Index cases were initially children (weight \u2265 15 kg); however, the study was extended to adults in March 2017. Each index case was associated with a cluster, consisting members of their household.<\/li>\n
- The cluster was randomly assigned in a 1:1 ratio to either receive oral ivermectin 200 \u03bcg\/kg with food (n = 507 from 142 households) or apply 5% permethrin cream from the head to toe overnight on days 0 and 10 (n = 568 from 147 households), with all children weighing below 15 kg receiving permethrin regardless of group assignment.<\/li>\n
- The primary outcome was the cluster-level cure rate at day 28, defined as a complete resolution of clinical signs and symptoms in all household members, including the index cases. Secondary outcomes included clinical cure at an individual level on day 28 for index cases only or all cluster participants and safety.<\/li>\n<\/ul>\n
TAKEAWAY:<\/strong><\/h2>\n
- \n
- Cluster-level cure rates were 71.8% for participants treated with ivermectin vs 88.5% for those treated with permethrin (percentage point difference [PPD], -16.7; 95% CI, -26.3 to -7.1), demonstrating the inferiority of ivermectin to permethrin.<\/li>\n
- Secondary outcomes showed the inferiority of ivermectin to permethrin, with cure rates of 76.6% vs 91.5% for index cases (PPD, -14.9; 95% CI, -23.6 to -6.2) and 85.3% vs 94.2% for all participants (PPD, -9.2; 95% CI, -14.9 to -3.5).<\/li>\n
- Intraclass correlation coefficients were higher for participants treated with permethrin than for those treated with ivermectin across all clusters (0.68; 95% CI, 0.61-0.75 vs 0.46; 95% CI, 0.37-0.56).<\/li>\n
- At least one cutaneous adverse event occurred in 9.9% of ivermectin-treated and 13.6% of permethrin-treated participants at the index level and in 2.2% and 3.3%, respectively, at the cluster level.<\/li>\n<\/ul>\n
IN PRACTICE:<\/strong><\/h2>\n
“The results showed the statistical superiority of permethrin,” the authors wrote. “In decision making in clinical practice, however, factors such as potential compliance, adherence, and ease of use, as well as molecular and clinical tolerance or resistance to scabicides and the skin condition of patients, should be considered when prescribing treatment for scabies,” they concluded.<\/p>\n
SOURCE:<\/strong><\/h2>\n
This study was led by Franck Boralevi, Department of Paediatric Dermatology, H\u00f4pital des Enfants, Groupe Hospitalier Pellegrin, Bordeaux, France. It was published online on January 06, 2026, in BMJ<\/em>.<\/p>\n
LIMITATIONS:<\/strong><\/h2>\n
The results could only be generalised to patients without diffuse eczematisation or extensive impetiginisation. Differences in the body surface area between the groups could have affected adherence to permethrin application. Treatment effectiveness might vary due to potential permethrin resistance in certain countries. Some participants self-reported cure assessment on day 28 rather than attending consultation, and data were largely missing for follow-up at day 56. Although recommended, the treatment of out-of-household contacts was not supervised, and no patient information leaflets were provided. This study did not account for social health determinants or standardise textile decontamination procedures.<\/p>\n
DISCLOSURES:<\/strong><\/h2>\n
This study was funded by the French Ministry of Health through Programme Hospitalier de Recherche Clinique and the French Society of Dermatology. Two authors reported serving as investigators for a phase 2 moxidectin Medicines Development for Global Health trial. Full disclosures are noted in the original article.<\/p>\n
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.<\/em><\/p>\n<\/div>\n<\/div>\n
\n
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