Paggi Riccardo, Pozzi Marco, Borchi Beatrice, Mantengoli Elisabetta, Bandini Giulia, Ipponi Alessandra, Chiarelli Annarita, Paolini Diana, Cecchi Michele, Arcangeli Giulio, Niccolini Fabrizio, Moggi Pignone Alberto, Bartoloni Alessandro, Zammarchi Lorenzo
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.
Infez Med. 2024 Dec 1;32(4):518-524. doi: 10.53854/liim-3204-10. eCollection 2024.
Scabies is a neglected disease that cause outbreaks in facilities such as hospitals and prisons. In Europe, treatment with 2 doses of ivermectin 200 mcg/kg, 7 days apart, is authorised and recommended especially in population mass treatment. We describe the management of a mass pre-emptive therapy of primary contacts of a confirmed case of classic scabies among health care workers.
Hospital personnel were evaluated, and at-risk contacts were treated with oral ivermectin 200 mcg/kg single dose if asymptomatic. Hospital staff were called after 7, 30, and 60 days after the first visit to assess presence of adverse drug reactions (ADRs) or symptoms compatible with scabies.
Among 27 patients evaluated, 19/27 (70.4%) received single dose ivermectin for scabies pre-emptive therapy. A total of 11/13 patients were nurses, and 8/14 were healthcare assistants. A total of 87 tablets of ivermectin were administered, with a total cost of 423.69 euros. Two people reported ADRs at 7 days; one and two patients reported possible ADRs at 30 and 60 days, respectively. The efficacy in preventing scabies was 100%.
To our knowledge, this is the first Italian experience in which a single dose of ivermectin has been implemented for mass pre-emptive therapy in asymptomatic primary contacts of classical scabies, showing excellent efficacy of the drug even when used as a single dose.
疥疮是一种被忽视的疾病，可在医院和监狱等场所引发疫情。在欧洲，已批准并推荐使用两剂伊维菌素，剂量为200微克/千克，间隔7天，尤其适用于群体治疗。我们描述了对一名确诊经典疥疮病例的医护人员密切接触者进行大规模预防性治疗的管理情况。
对医院工作人员进行了评估，无症状的高危接触者接受单剂量200微克/千克的口服伊维菌素治疗。在首次就诊后的7天、30天和60天对医院工作人员进行回访，以评估药物不良反应（ADR）或与疥疮相符的症状。
在评估的27名患者中，19/27（70.4%）接受了单剂量伊维菌素进行疥疮预防性治疗。共有11/13名患者为护士，8/14名患者为医护助理。共发放了87片伊维菌素，总成本为423.69欧元。2人在7天时报告了药物不良反应；分别有1名和2名患者在30天和60天时报告了可能的药物不良反应。预防疥疮的有效率为100%。
据我们所知，这是意大利首次对经典疥疮无症状密切接触者采用单剂量伊维菌素进行大规模预防性治疗的经验，表明该药物即使单剂量使用也具有出色的疗效。
