First Documentation of In Vivo and In Vitro Ivermectin Resistance in Sarcoptes scabiei

Ivermectin is increasingly being used to treat scabies, especially crusted (Norwegian) scabies. However, treatment failures, recrudescence, and reinfection can occur, even after multiple doses. Ivermectin resistance has been documented for some intestinal helminths in animals with intensive ivermect...

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Bibliographic Details
Published in:Clinical infectious diseases 2004-07, Vol.39 (1), p.e8-e12
Main Authors: Currie, Bart J., Harumal, Pearly, McKinnon, Melita, Walton, Shelley F.
Format: Article
Language:English
Subjects:
Adult
Animals
Drug Resistance - physiology
Female
Humans
Insecticides - pharmacology
Ivermectin - pharmacology
Male
Middle Aged
Sarcoptes scabiei
Sarcoptes scabiei - drug effects
Sarcoptidae
Scabies - parasitology
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Summary:Ivermectin is increasingly being used to treat scabies, especially crusted (Norwegian) scabies. However, treatment failures, recrudescence, and reinfection can occur, even after multiple doses. Ivermectin resistance has been documented for some intestinal helminths in animals with intensive ivermectin exposure. Ivermectin resistance has also been induced in arthropods in laboratory experiments but, to date, has not been documented among arthropods in nature. We report clinical and in vitro evidence of ivermectin resistance in 2 patients with multiple recurrences of crusted scabies who had previously received 30 and 58 doses of ivermectin over 4 and 4.5 years, respectively. As predicted, ivermectin resistance in scabies mites can develop after intensive ivermectin use.
ISSN:1058-4838
1537-6591
DOI:10.1086/421776