Prescrire Int. 2002 Oct;11(61):137-40.
(1) Ivermectin is the first oral drug to be licensed in France for the treatment of scabies. (2) In common scabies, three small trials suggest that ivermectin is about as effective as topical preparations. (3) Several cohort studies have shown that ivermectin can control outbreaks of scabies (especially in institutions) and also in endemic areas. (4) There are no clinical trial data on ivermectin in crusted scabies. Case series suggest that combining ivermectin with topical treatments may increase efficacy. (5) Ivermectin seems to have few, mostly mild short-term side effects in adults. There are no reports of ivermectin treatment in infants weighing less than 15 kg or in breast-feeding infants. Data on about 400 pregnant women treated with ivermectin are reassuring. (6) In a small cohort of elderly patients, ivermectin used after topical preparations coincided with excess mortality 6 months later. Subsequent studies were reassuring, but all adverse events (including death) in elderly patients treated with ivermectin must none the less be notified. (7) In practice, oral ivermectin is effective against scabies and is thus an alternative to topical treatments. Its single-dose administration facilitates treatment, especially during outbreaks.
(1) 伊维菌素是法国首个获批用于治疗疥疮的口服药物。(2) 在普通疥疮方面,三项小型试验表明伊维菌素的疗效与局部用药制剂相当。(3) 多项队列研究表明,伊维菌素可控制疥疮的暴发(尤其是在机构中),在流行地区也有此效果。(4) 目前尚无关于伊维菌素治疗结痂性疥疮的临床试验数据。病例系列研究表明,将伊维菌素与局部治疗联合使用可能会提高疗效。(5) 伊维菌素在成人中似乎很少有短期副作用,且大多为轻度。尚无关于体重不足15公斤的婴儿或哺乳期婴儿使用伊维菌素治疗的报告。约400名接受伊维菌素治疗的孕妇的数据令人安心。(6) 在一小群老年患者中,在局部用药制剂之后使用伊维菌素与6个月后的额外死亡率相关。后续研究结果令人安心,但仍必须报告所有接受伊维菌素治疗的老年患者的不良事件(包括死亡)。(7) 在实际应用中,口服伊维菌素对疥疮有效,因此是局部治疗的一种替代方法。其单剂量给药便于治疗,尤其是在暴发期间。