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AI-Generated response:

What's the simplest treatment for scabies in an infant?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

The simplest treatment for scabies in an infant is the application of 5% permethrin cream.

  • Permethrin 5% cream should be massaged into the skin from the head to the soles of the feet, including the scalp, temple, and forehead in infants.

  • The cream should be left on for 8 to 14 hours before washing it off.

  • One application is generally curative, but retreatment is necessary if living mites are observed after 7 to 14 days.

  • Permethrin is considered safe for use in infants aged 2 months and older.[1-3]

  • All family members and close contacts should also be treated to prevent re-infestation.[4]

Additional info

Permethrin is the preferred treatment for scabies in infants due to its efficacy and safety profile. It is important to ensure that the cream is applied thoroughly to all parts of the body, as scabies mites can infest even small creases and folds of the skin. Additionally, environmental decontamination is crucial; washing bedding, clothing, and other fabric items in hot water and drying them on a hot cycle can help eliminate mites that might cause re-infestation. While permethrin is generally well-tolerated, some infants may experience mild skin irritation or temporary worsening of itching after application. It is essential to monitor the infant for any signs of adverse reactions and ensure that the treatment is applied correctly to maximize effectiveness and minimize risks.

References

Reference 1

1.

Scabies, Elsevier ClinicalKey Clinical Overview

Treatment Anthelmintics 5% permethrin cream Treat infants and young children with permethrin Preferred first line therapy for classic scabies: Permethrin Topical cream; Infants, Children, and Adolescents 2 months to 17 years: Massage 5% topical cream into the skin from the head to the soles of the feet. Wash off after 8 to 14 hours. One application is generally curative. Retreatment is indicated if living mites persist after 7 to 14 days of initial treatment. Permethrin Topical cream; Adults: Massage 5% topical cream into the skin from the head to the soles of the feet. Usually 30 grams is sufficient for the average adult. Wash off after 8 to 14 hours. One application is generally curative. Retreatment is indicated if living mites persist after 7 to 14 days of initial treatment. For crusted scabies, apply as part of dual therapy with ivermectin: Permethrin Topical cream; Adults: Apply a full body application (all body parts from neck down) of permethrin 5% cream topically daily for 7 days and then 2 times weekly until cure in combination with oral ivermectin. Ivermectin (oral administration) Taking ivermectin with a meal increases bioavailability Safety for children weighing less than 15 kg has not been determined Given limited data on ivermectin use in pregnant and lactating patients, permethrin is the preferred treatment; it is likely low risk for pregnant patients and is likely compatible with breastfeeding Off-label, second line therapy for classic scabies: Ivermectin Oral tablet; Adults: 200 mcg/kg/dose PO as a single dose, with a repeat dose 2 weeks later. For crusted scabies, apply as part of dual therapy with 5% permethrin cream:

Reference 2

2.

Permethrin, Elsevier ClinicalKey Drug Monograph Content last updated: September 5, 2023

Indications And Dosage **for the treatment of scabies infection** Topical dosage (Elimite 5% cream) Adults: Massage 5% topical cream into the skin from the head to the soles of the feet. Scabies rarely infests the scalp of adults, although the hairline, neck, temple, and forehead may be infested in geriatric patients. Usually 30 grams is sufficient for the average adult. Wash cream off after 8 to 14 hours. One application is generally curative. Although pruritus may persist after treatment, this is rarely a sign of treatment failure and is not an indication for retreatment. Retreatment is indicated if living mites persist after 7 to 14 days of initial treatment. Infants, Children, and Adolescents 2 months to 17 years: Massage 5% topical cream into the skin from the head to the soles of the feet. Wash cream off after 8 to 14 hours. One application is generally curative. Although pruritus may persist after treatment, this is rarely a sign of treatment failure and is not an indication for retreatment. Retreatment is indicated if living mites persist after 7 to 14 days of initial treatment. **for the treatment of crusted (Norwegian) scabies † infection** Topical dosage (Elimite 5% cream) Adults: Apply a full body application (all body parts from neck down) of elimite 5% cream topically daily for 7 days and then 2 times weekly until cure in combination with oral ivermectin. Retreatment 2 weeks after the initial treatment regimen can be considered for those persons who are still symptomatic or when live mites are observed. Use of an alternative regimen is recommended for those persons who do not respond initially to the recommended treatment.

Dosage And Administration DOSAGE AND ADMINISTRATION Adults and children – Thoroughly massage Permethrin Cream, 5% into the skin from the head to the soles of the feet. Scabies rarely infests the scalp of adults, although the hairline, neck, temple, and forehead may be infested in infants and geriatric patients. Usually 30 grams is sufficient for an average adult. The cream should be removed by washing (shower or bath) after 8 to 14 hours. Infants should be treated on the scalp, temple, and forehead. ONE APPLICATION IS GENERALLY CURATIVE .

Reference 3

3.

Food and Drug Administration (DailyMed). ELIMITE. 2024. Publish date: January 3, 2024

Dosage And Administration DOSAGE AND ADMINISTRATION Adults and Children - Thoroughly massage ELIMITE (permethrin) ® (ELIMITE (permethrin)) 5% Cream into the skin from the head to the soles of the feet. Scabies rarely infests the scalp of adults, although the hairline, neck, temple, and forehead may be infested in infants and geriatric patients. Usually 30 grams is sufficient for an average adult. The cream should be removed by washing (shower or bath) after 8 to 14 hours. Infants should be treated on the scalp, temple, and forehead. ONE APPLICATION IS GENERALLY CURATIVE. Patients may experience persistent pruritus after treatment. This is rarely a sign of treatment failure and is not an indication for retreatment. Demonstrable living mites after 14 days indicate that retreatment is necessary.

Reference 4

4.

Congenital and Infantile Cutaneous Lesions, Elsevier ClinicalKey Clinical Overview

Treatment Topical calcineurin inhibitors (eg, 2% crisaborole ointment) can also be used Secondary bacterial infections should be considered if the flares do not respond to typical treatment Scabies 2-pronged approach with use of scabicide and fomite control Topical scabicides are applied overnight to the entire skin surface, including creases Permethrin is the preferred treatment and should be repeated in 1 week All family members and those living in the same household should also be treated Other treatment options include precipitated sulfur (studied in children younger than 2 months) All linens, bedding, and clothing should be washed with hot water and soap. Clothing that cannot be washed right away can be stored in plastic bags until it can be washed Pruritus is common and can be treated with low-potency topical steroids In older infants, can consider oral antihistamines

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