Pharmacists urgently urge government to approve ivermectin, the controversial ‘horse anthelmintic’ drug, to treat skin mite infections amid reports of rising cases and widespread treatment shortages there is
A highly contagious disease, scabies causes intense itching, a raised rash, and is easily spread through close contact with other people.
Over the past year, the epidemic has surged, especially among older people in nursing homes and young people in college. Experts now warn that some cases are becoming harder to treat.
Boulevard chemists say they routinely run out of stocks of the main drugs used for skin conditions — over-the-counter creams called permethrin and malathion.
Experts believe the antiparasitic drug ivermectin may be the answer. It is used in veterinary medicine, and is therefore commonly referred to as an equine anthelmintic, and is routinely administered to children and adults in mainland Europe and elsewhere for the treatment or prevention of parasitic infections. increase.
Powerful tick: Sarcoptes scabiei that causes scabies infection
Ivermectin, despite a lack of credible evidence, could be an adequate treatment, and even an alternative to vaccination, as advocated by fringe healthcare practitioners to help prevent the spread of the novel coronavirus pandemic. gained notoriety inside.
The drug, despite a lack of reliable evidence, has been discontinued during the COVID-19 pandemic as end-of-life medical practitioners argued it could be an adequate treatment and even an alternative to vaccination. became infamous for
However, only one product containing ivermectin is currently licensed for use in the UK. It is a cream for rosacea skin disease and is called Soolantra.
“Treatments for scabies have been on and off the short-list for some time, and ivermectin is a safe and effective treatment,” said Dr. Layla Hambeck, chief executive of the Independent Multipharmacy Association. I know,’ he said. But the pharmacist can’t pass it. Dermatologists can prescribe it “off label,” but referrals take a tremendous amount of time and resources.
“Scabies is a disturbing and stressful condition for patients because of its distressing symptoms, and it can be transmitted to others. We have issued a special procedure to dictate what alternatives we allow to be used in. We need to issue this now to avoid further suffering.”
Scabies is caused by the body’s immune response to tiny mites called Sarcoptes scabiei and their saliva, eggs, and feces. Anyone can be affected, but it especially affects the elderly, young, and those with weakened immune systems. It is most commonly spread by frequent or prolonged skin-to-skin contact, and outbreaks tend to occur where people live nearby.
A ward at Inverness Hospital was closed last month following an outbreak of scabies, and the Norfolk County Council recently sent a letter to schools warning teachers to be aware of the condition. In addition to a raised red rash, tick-burrowed “marks” under the skin are also telltale signs. It causes severe itching that interferes with sleep. This can exacerbate the condition and lead to bacterial infections.
British guidance recommends the use of permethrin or malathion cream, which should be applied all over the body, including under the nails. It should last up to 24 hours and repeat after a week.
As an alternative, there is evidence that ivermectin taken in tablet form is safe and equally effective. European regulators recommend two doses two weeks apart for standard scabies. It can be used in combination with cream in more severe cases.
However, according to the UK Health and Safety Agency, only specialist doctors (usually dermatologists) can issue prescriptions in the UK to treat serious cases or outbreaks.
Dr Tess MacPherson of the British Association of Dermatologists said: “Dermatologists, especially those working with young people, are finding more and more difficult cases to treat.”
Some studies suggest that this may be because scabies mites have become resistant to standard treatments, just as the lice-causing lice have become immune to permethrin. However, other studies have shown that this drug is still effective.
Dr. McPherson added, “It’s very likely.” [in cases where treatment doesn’t seem to work] People aren’t applying it properly, or they’re wearing it long enough (at least 12 hours is needed, but many people get results in 24 hours), or people around them are treating it. It is re-exposed because it is not
“We need a national program to get through this…Ivermectin is not a bad option if people have nothing else to offer.”
Dr. Lucy Pollock, a geriatrician, has experienced two outbreaks in nursing homes in the past year, but never before. “It’s really sad because they cause so much pain. Scabies in older people is difficult to diagnose because the skin can be itchy for many reasons,” Dr. Pollock said. rice field.
“It’s not easy to double-apply the cream to everyone, including staff. Using one tablet may be a more effective approach.”
