Single dose ivermectin for scabies pre-emptive therapy among healthcare workers in Careggi University Hospital, Florence, Italy.

Introduction: Scabies is a neglected disease that cause outbreaks in facilities such as hospitals and prisons. In Europe, treatment with 2 doses of ivermectin 200 mcg/kg, 7 days apart, is authorised and recommended especially in population mass treatment. We describe the management of a mass pre-emptive therapy of primary contacts of a confirmed case of classic scabies among health care workers.

Patients and methods: Hospital personnel were evaluated, and at-risk contacts were treated with oral ivermectin 200 mcg/kg single dose if asymptomatic. Hospital staff were called after 7, 30, and 60 days after the first visit to assess presence of adverse drug reactions (ADRs) or symptoms compatible with scabies.

Results: Among 27 patients evaluated, 19/27 (70.4%) received single dose ivermectin for scabies pre-emptive therapy. A total of 11/13 patients were nurses, and 8/14 were healthcare assistants. A total of 87 tablets of ivermectin were administered, with a total cost of 423.69 euros. Two people reported ADRs at 7 days; one and two patients reported possible ADRs at 30 and 60 days, respectively. The efficacy in preventing scabies was 100%.

Discussion and conclusions: To our knowledge, this is the first Italian experience in which a single dose of ivermectin has been implemented for mass pre-emptive therapy in asymptomatic primary contacts of classical scabies, showing excellent efficacy of the drug even when used as a single dose.