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Topical permethrin and oral ivermectin are the two most-prescribed scabicides. They have different mechanisms, and each can work as monotherapy for uncomplicated (i.e., noncrusted) scabies infestations. Two large reviews, conducted in 2007 and 2018, yielded conflicting efficacy data for cure rates for these two agents, and the U.S. CDC recommends choosing treatment based on patient preference.
In the appropriately named SCRATCH (Scabies Randomized Trial in Children and Adults) trial, French researchers randomized 300 household adult–child clusters (≈1000 people) to either whole-body application of 5% permethrin or oral ivermectin (200 μg/kg) on days 0 and 10. Scabies diagnoses were confirmed by dermatologists and cure was assessed on …