Meinking T L, Taplin D, Hermida J L, Pardo R, Kerdel F A
Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL, USA.
N Engl J Med. 1995 Jul 6;333(1):26-30. doi: 10.1056/NEJM199507063330105.
Ivermectin is an anthelmintic agent that has been a safe, effective treatment for onchocerciasis (river blindness) when given in a single oral dose of 150 to 200 micrograms per kilogram of body weight. Anecdotal reports of improvement in patients who suffered from infestation with the mite Sarcoptes scabiei suggest that the ectoparasitic disease scabies might be treated with ivermectin.
We conducted an open-label study in which ivermectin was administered in a single oral dose of 200 micrograms per kilogram to 11 otherwise healthy patients with scabies and to 11 patients with scabies who were also infected with the human immunodeficiency virus (HIV), 7 of whom had the acquired immunodeficiency syndrome. All patients received a full physical and dermatologic examination; scrapings from the skin of all patients tested positive for scabies. Patients were reexamined two and four weeks after treatment, when the scrapings for scabies were repeated. The patients used no other scabicides during the 30 days before ivermectin treatment or during the 4-week study period.
None of the 11 otherwise healthy patients had evidence of scabies four weeks after a single dose of ivermectin. Of the 11 HIV-infected patients, 2 had < or = 10 scabies lesions before treatment, 3 had 11 to 49 lesions, 4 had > or = 50 lesions, and 2 had heavily crusted skin lesions. In eight of the patients the scabies was cured after a single dose of ivermectin. Two patients received a second dose two weeks after the first. Ten of the 11 patients with HIV infection (91 percent) had no evidence of scabies four weeks after their first treatment with ivermectin.
The anthelmintic agent ivermectin, given in a single oral dose, is an effective treatment for scabies in otherwise healthy patients and in many patients with HIV infection.
伊维菌素是一种驱虫剂，当以每千克体重150至200微克的单次口服剂量给药时，它一直是治疗盘尾丝虫病（河盲症）的一种安全、有效的药物。有轶事报道称，感染疥螨的患者病情有所改善，这表明伊维菌素可能可用于治疗寄生虫性疾病疥疮。
我们进行了一项开放标签研究，对11名其他方面健康的疥疮患者和11名同时感染人类免疫缺陷病毒（HIV）的疥疮患者（其中7名患有获得性免疫缺陷综合征）给予每千克体重200微克的单次口服伊维菌素剂量。所有患者均接受了全面的体格和皮肤科检查；所有患者的皮肤刮片检测疥疮均呈阳性。在治疗后两周和四周对患者进行复查，同时再次进行疥疮刮片检查。在伊维菌素治疗前30天或4周的研究期间，患者未使用其他杀疥剂。
11名其他方面健康的患者在单次服用伊维菌素四周后均无疥疮迹象。在11名感染HIV的患者中，2名在治疗前有≤10个疥疮皮损；3名有11至49个皮损；另外4名有≥50个皮损；2名有严重结痂的皮肤病变。8名患者在单次服用伊维菌素后疥疮治愈。2名患者在第一次服药两周后接受了第二次服药。11名感染HIV的患者中有10名（91%）在首次接受伊维菌素治疗四周后无疥疮迹象。
单次口服驱虫剂伊维菌素对其他方面健康的患者以及许多感染HIV的患者的疥疮是一种有效的治疗方法。
