Lê M-S, Richard M-A, Baumstarck K, Hesse S, Gaudy-Marqueste C, Grob J-J, Mallet S
UMR 911, Inserm CRO2, « centre de recherche en oncologie biologique et oncopharmacologie », service de dermatologie, hôpital Timone, Aix-Marseille université, Assistance publique des Hôpitaux de Marseille, 13005 Marseille, France.
UMR 911, Inserm CRO2, « centre de recherche en oncologie biologique et oncopharmacologie », service de dermatologie, hôpital Timone, Aix-Marseille université, Assistance publique des Hôpitaux de Marseille, 13005 Marseille, France.
Ann Dermatol Venereol. 2017 May;144(5):341-348. doi: 10.1016/j.annder.2016.12.008. Epub 2017 Apr 10.
Scabies has been on the rise in France in recent years and has posed therapeutic problems, mainly due to the withdrawal of benzyl benzoate. The objective of this study was to describe prescribing practices for scabies in children.
A national survey was conducted by means of a standardized questionnaire covering various clinical situations of scabies and the drugs used preferentially according to age, which was sent out between December 2014 and March 2015 to members of the clinical research group of the French Society of Paediatric Dermatology.
Of the 38 experts contacted, 20 replied. For a typical case of scabies, 55% of the experts initially prescribed oral ivermectin for children aged 6 years, 15% prescribed ivermectin in children aged 2 years, and 5% in infants aged 3 months. Ivermectin was more widely prescribed after failure of prior treatment or recurrence of scabies, on skin lesions or impetigo, if precarious, especially for profuse hyperkeratotic scabies. A total of 35% of the experts reported no prescribing restrictions with regard to patient age or weight. Discrepancies were observed concerning the mode of administration and the time between consecutive doses. Esdepallethrin remained the preferred local treatment among the experts (38% of all topical prescriptions) except in asthmatic children, while permethrin was the least-prescribed topical agent.
This study confirms the heterogeneity of our practices. Formal expert recommendations are awaited, particularly concerning the use of ivermectin in infants.
近年来，疥疮在法国呈上升趋势，并引发了治疗问题，主要原因是苯甲酸苄酯的停用。本研究的目的是描述儿童疥疮的处方用药情况。
通过标准化问卷进行了一项全国性调查，问卷涵盖疥疮的各种临床情况以及根据年龄优先使用的药物，于2014年12月至2015年3月发送给法国儿科学会皮肤病学临床研究组的成员。
在联系的38位专家中，20位给予了回复。对于典型的疥疮病例，55%的专家最初为6岁儿童开具口服伊维菌素，15%为2岁儿童开具伊维菌素，5%为3个月大的婴儿开具伊维菌素。在先前治疗失败或疥疮复发后、出现皮肤病变或脓疱疮（若情况不稳定）时，尤其是对于大量角化过度型疥疮，伊维菌素的处方更为广泛。共有35%的专家报告在患者年龄或体重方面没有处方限制。在给药方式和连续给药间隔时间方面存在差异。除哮喘儿童外，炔丙菊酯仍是专家们首选的局部治疗药物（占所有局部用药处方的38%），而氯菊酯是处方最少的局部用药。
本研究证实了我们做法的异质性。期待正式的专家建议，特别是关于伊维菌素在婴儿中的使用。
