Orally administered treatments Benefits

We found one systematic review examining two small RCTs, one of which had inadequate follow up. A placebo-controlled RCT (55 adults and children) found that significantly more people treated with ivermectin, 200 microgram/kg, (23/29 (79%)) were free from symptoms at 7 days compared with those treated with placebo (2/26 (8%) RR 10-3, CI 2-7-39-6). The code was then broken and the controls and all patients who had not improved received ivermectin.48 A comparative RCT (44 people) found no significant difference in improvement of lesions between ivermectin, 100 microgram/kg, (16/23 (70%)) and benzyl benzoate 10%, applied twice over 2 days (10/21 (48%)) at 30 days (RR 1-46, CI 0-9-2-5).43

We also found one RCT (85 people) comparing ivermectin, 200 microgram/kg, with 5% permethrin cream, evaluated at 1, 2, 4 and 8 weeks.49 In this study a single dose of ivermectin relieved symptoms in significantly fewer people (28/40 (70%)) than permethrin (44/45 (98%) RR 0-72, CI 0-6-0-9), but when a second dose of treatment was given after 2 weeks there was no significant difference in the improvement rate between the ivermectin group (38/40 (95%)) and the permethrin group, in which everyone was cured . A second RCT (53 people, 43 completing the study) found ivermectin, 150-200 microgram/kg, to be statistically equivalent to 1% lindane lotion.50 After 15 days 14/19 (74%) had improved with ivermectin, compared with 13/24 (46%) treated with lindane (RR 1-36, CI 0-9-2-1). At 29 days all but one person in each group were cured (18/19 (95%) with ivermectin versus 23/24 (96%) with lindane; RR 0-99, CI 0-9-1-1).

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