age and anyone who had received pe- diculosis treatment in the last 2 weeks were excluded. Statistical analysis was performed using a chi-square test. The primary endpoint was not clearly stated, but cure rates were evaluated on days 8, 15, and 29. On day 8, 31 patients (77.5%) in the iver- mectin group and 35 (87.5%) in the malathion group were cured, defined as the absence of live, moving lice ( p = 0.23). On day 15, cure was achieved in 37 patients (92.5%) in the ivermectin group and 38 (95.0%) in the malathion group ( p = 0.64). On day 29, however, sustained cure was reported in only 30 patients (75%) in the ivermectin group and 32 (80%) in the malathion group ( p = 0.59); this finding was attributed to possible reinfestation with head lice carried by family members or contacts or improper cleaning of clothes and bedding. The investigator concluded that there was no statistically signifi- cant difference in the effectiveness of the 2 treatments but encouraged use of a second dose of ivermectin in some patients due to its lack of ovi- cidal action. He noted that an advan- tage of oral ivermectin is that admin- istration can be observed, which may overcome problems associated with administration of topical products. No major adverse events were re- ported in the study. Stinging of the skin and eye irritation were observed in 3 patients in the malathion group. Two patients in the ivermectin group reported increased pruritus, which resolved within 3 days. Limitations of this study included a lack of treatment blinding and the possibility of misuse of malathion lotion due to patient ap- plication offsite; in addition, patients at only 1 study site were included, and the primary endpoint was not clear. Ameen et al. Ameen and col- leagues 15 conducted a study to evalu- ate the safety and effectiveness of oral ivermectin in a rural indigenous pop- ulation of children in Mexico. Many of these children did not have access to running water, making treatment with topical products problematic. The children received a 200- µ g/kg oral dose of ivermectin and a second dose if infestations continued after 1 week. All enrolled children weighed more than 15 kg, were 6–15 years of age, had not received any pediculosis treatment within the last month, and were not receiving any interacting medications. Infestation was defined as the presence of adult lice, nymphs, or viable nits. A total of 46 children were en- rolled, but only 44 were included in the analysis; the other 2 did not return for follow-up visits. The study par- ticipants had a mean age of 9.8 years and a mean weight of 26.4 kg, and 67% were female. At week 1, research- ers noted that all adult lice had been eradicated in all participants; only 18 (41%) still had viable nits and received a second dose. On follow-up at week 2, 30 children (68.2%) still had visible nits, but on inspection all nits were considered nonviable. Excoriations had resolved in all children, and only 12 (27.3%) still had complaints of pru- ritus, although they noted a decrease in its intensity. The authors concluded that oral ivermectin is effective and
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- Fall '17
- Farhana Ferdous
- Head louse, Pediculosis, Body louse, Louse, Ivermectin