JAC Advance Access originally published online on May 1, 2008
Journal of Antimicrobial Chemotherapy 2008 62(2):404-409; doi:10.1093/jac/dkn161
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Original research |
The effect of a single dose of oral ivermectin on pruritus in the homeless
1 Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine, 13185 Marseille, France 2 Service d'Accueil des Urgences, Hôpital Nord, 13915 Marseille, France 3 Pôle des Maladies Infectieuses et Tropicales, Hôpitaux de Marseille, 13385 Marseille, France 4 Institut de Médecine Tropicale du Service de Santé des Armées, URBEP, 13006 Marseille, France 5 Pharmacie Centrale Hôpital Nord, 13915 Marseille, France
Received 23 January 2008; returned 26 February 2008; revised 12 March 2008; accepted 14 March 2008
* Correspondence address. Unité des Rickettsies, CNRS UPRESA 6020, Faculté de Médecine, 27 bd Jean Moulin, 13385 Marseille Cedex 5, France. Tel: +33-491-32-43-75; Fax: +33-491-38-77-72; E-mail: philippe.brouqui{at}medecine.univ-mrs.fr
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.
Keywords: body louse , scabies , skin infection , infection control , clinical trial
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