Efficacy of 5% permethrin-2% fusidic acid cream compared to 5% permethrin-placebo in the treatment of impetiginized scabies

Introduction: Scabies is caused by Sarcoptes scabiei var hominis, often causing secondary bacterial infections, especially by Streptococcus pyogenes and Staphylococcus aureus. Permethrin 5% cream is the first-line of treatment that is recommended, combined with Fusidic acid 2% cream as the first-li...

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Main Authors: Aninda Marina, Sri Linuwih Menaldi, Endi Novianto, Sandra Widaty
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2022-06-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/15205
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author Aninda Marina
Sri Linuwih Menaldi
Endi Novianto
Sandra Widaty
author_facet Aninda Marina
Sri Linuwih Menaldi
Endi Novianto
Sandra Widaty
author_sort Aninda Marina
collection DOAJ
description Introduction: Scabies is caused by Sarcoptes scabiei var hominis, often causing secondary bacterial infections, especially by Streptococcus pyogenes and Staphylococcus aureus. Permethrin 5% cream is the first-line of treatment that is recommended, combined with Fusidic acid 2% cream as the first-line topical antibiotic. We investigated the efficacy of a combination of permethrin 5% cream and fusidic acid 2% cream for the treatment of impetiginized scabies. Methodology: A double-blind, randomized clinical trial was organized at two Islamic boarding schools in Bogor, West Java, Indonesia. Forty subjects were randomly allocated into the intervention group (permethrin 5% and fusidic acid 2%; n = 20), and the control group (permethrin 5% and placebo; n = 20). Treatment efficacy was determined through the visual analogue scale (VAS) for pruritus and pain, and by examining bacterial cultures. Results: Treatment efficacy in the intervention group was higher than in the control group on day 7 (80% vs. 35%) and day 14 (95% vs 35%, p ≤ 0.001, RR 2.714) with decreasing VAS for pruritus (p = 0.04) and pain (p = 0.035). The most common bacterium was Staphylococcus aureus. Some minor adverse effects such as itch and heat occurred temporarily. Conclusions: Treating impetiginized scabies with permethrin 5% and fusidic acid 2% cream is more effective than treating with only 5% premethrin. The most common bacterium causing secondary infection in impetiginized scabies is Staphylococcus aureus.
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spelling doaj-art-487e43e2d8e54c47afcd9bdfb8fb7a4f2025-08-20T02:16:06ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802022-06-01160610.3855/jidc.15205Efficacy of 5% permethrin-2% fusidic acid cream compared to 5% permethrin-placebo in the treatment of impetiginized scabiesAninda Marina0Sri Linuwih Menaldi1Endi Novianto2Sandra Widaty3Dermatology and Venereology Department, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo General Hospital, Jakarta, IndonesiaDermatology and Venereology Department, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo General Hospital, Jakarta, IndonesiaDermatology and Venereology Department, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo General Hospital, Jakarta, IndonesiaDermatology and Venereology Department, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia Introduction: Scabies is caused by Sarcoptes scabiei var hominis, often causing secondary bacterial infections, especially by Streptococcus pyogenes and Staphylococcus aureus. Permethrin 5% cream is the first-line of treatment that is recommended, combined with Fusidic acid 2% cream as the first-line topical antibiotic. We investigated the efficacy of a combination of permethrin 5% cream and fusidic acid 2% cream for the treatment of impetiginized scabies. Methodology: A double-blind, randomized clinical trial was organized at two Islamic boarding schools in Bogor, West Java, Indonesia. Forty subjects were randomly allocated into the intervention group (permethrin 5% and fusidic acid 2%; n = 20), and the control group (permethrin 5% and placebo; n = 20). Treatment efficacy was determined through the visual analogue scale (VAS) for pruritus and pain, and by examining bacterial cultures. Results: Treatment efficacy in the intervention group was higher than in the control group on day 7 (80% vs. 35%) and day 14 (95% vs 35%, p ≤ 0.001, RR 2.714) with decreasing VAS for pruritus (p = 0.04) and pain (p = 0.035). The most common bacterium was Staphylococcus aureus. Some minor adverse effects such as itch and heat occurred temporarily. Conclusions: Treating impetiginized scabies with permethrin 5% and fusidic acid 2% cream is more effective than treating with only 5% premethrin. The most common bacterium causing secondary infection in impetiginized scabies is Staphylococcus aureus. https://jidc.org/index.php/journal/article/view/15205impetiginized scabiesfusidic acidpermetherinvisual analogue scaleefficacyStaphylococcus aureus
spellingShingle Aninda Marina
Sri Linuwih Menaldi
Endi Novianto
Sandra Widaty
Efficacy of 5% permethrin-2% fusidic acid cream compared to 5% permethrin-placebo in the treatment of impetiginized scabies
Journal of Infection in Developing Countries
impetiginized scabies
fusidic acid
permetherin
visual analogue scale
efficacy
Staphylococcus aureus
title Efficacy of 5% permethrin-2% fusidic acid cream compared to 5% permethrin-placebo in the treatment of impetiginized scabies
title_full Efficacy of 5% permethrin-2% fusidic acid cream compared to 5% permethrin-placebo in the treatment of impetiginized scabies
title_fullStr Efficacy of 5% permethrin-2% fusidic acid cream compared to 5% permethrin-placebo in the treatment of impetiginized scabies
title_full_unstemmed Efficacy of 5% permethrin-2% fusidic acid cream compared to 5% permethrin-placebo in the treatment of impetiginized scabies
title_short Efficacy of 5% permethrin-2% fusidic acid cream compared to 5% permethrin-placebo in the treatment of impetiginized scabies
title_sort efficacy of 5 permethrin 2 fusidic acid cream compared to 5 permethrin placebo in the treatment of impetiginized scabies
topic impetiginized scabies
fusidic acid
permetherin
visual analogue scale
efficacy
Staphylococcus aureus
url https://jidc.org/index.php/journal/article/view/15205
work_keys_str_mv AT anindamarina efficacyof5permethrin2fusidicacidcreamcomparedto5permethrinplacebointhetreatmentofimpetiginizedscabies
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AT endinovianto efficacyof5permethrin2fusidicacidcreamcomparedto5permethrinplacebointhetreatmentofimpetiginizedscabies
AT sandrawidaty efficacyof5permethrin2fusidicacidcreamcomparedto5permethrinplacebointhetreatmentofimpetiginizedscabies