The effect of a single dose of oral ivermectin on pruritus in the homeless

Background Homeless people commonly present with ectoparasite-based pruritus. We evaluated the efficacy of a single dose of ivermectin to reduce the pruritus prevalence in a homeless population. Methods We conducted a randomized, double-blind, placebo-controlled trial from January 2006 to April 2006...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2008-08, Vol.62 (2), p.404-409
Main Authors: Badiaga, Sékéné, Foucault, Cédric, Rogier, Christophe, Doudier, Barbara, Rovery, Clarisse, Dupont, Hervé Tissot, Castro, Pierre, Raoult, Didier, Brouqui, Philippe
Format: Article
Language:English
Subjects:
Administration, Oral
Adult
Animals
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
body louse
clinical trial
Clinical trials
Dermatology
Double-Blind Method
Drug therapy
France
Homeless people
Homeless Persons
Humans
infection control
Insecticides - administration & dosage
Insecticides - therapeutic use
Ivermectin - administration & dosage
Ivermectin - therapeutic use
Lice Infestations - drug therapy
Medical sciences
Middle Aged
Parasites
Pediculus - drug effects
Pharmacology. Drug treatments
Placebos - administration & dosage
Pruritus - drug therapy
scabies
skin infection
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Summary:Background Homeless people commonly present with ectoparasite-based pruritus. We evaluated the efficacy of a single dose of ivermectin to reduce the pruritus prevalence in a homeless population. Methods We conducted a randomized, double-blind, placebo-controlled trial from January 2006 to April 2006 in two homeless shelters in the city of Marseille, France. Homeless people complaining of pruritus were randomized to receive either ivermectin (24 mg) or placebo. Follow-up visits were planned at day 14 and day 28 after the inclusion to assess the outcome of pruritus. Results Forty-two subjects with pruritus were randomized to the ivermectin group and 40 to the placebo group. On day 14, pruritus was reported by significantly more subjects in the placebo group than those in the ivermectin group for both the per-protocol (PP) population (91.42% versus 68.57%, P = 0.014) and the intention-to-treat (ITT) population (92.5% versus 73.80%, P = 0.038). No significant effect was observed at day 28. Ivermectin was the only independent factor associated with the absence of pruritus at day 14 in both PP population [OR: 4.60 (95% CI:1.13; 18.73), P = 0.033] and ITT population [OR: 4.38 (95% CI: 1.07; 17.77), P = 0.039]. Conclusions A single dose of oral ivermectin has a transient beneficial effect on the reduction of the prevalence of pruritus in the homeless population. More studies are required to assess the efficacy of multiple repeated treatments with ivermectin to reduce scabies and body lice endemic among homeless people with pruritus and the impact of such treatment on this population.
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dkn161