{ "schema_version": 1, "kind": "condition", "id": "scabies", "name": "Scabies infestation", "category": "infectious", "sources": "CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Scabies - Recommended Regimens and Special Considerations, with the dose from MSF Essential Drugs 2024, IVERMECTIN oral: ordinary scabies row: \"Child over 15 kg and adult: 200 micrograms/kg single dose. A single dose may be sufficient\", with a second dose one week later to reduce the risk of treatment failure. MSF puts that second dose at one week against the 14 days given here, which follows the CDC guideline, and MSF states the same 15 kg floor. · CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Scabies - Recommended Regimens and Special Considerations · Permethrin 5% w/w Cream SmPC section 4.2 Posology and method of administration (eMC product 15508) · Egyptian National Drug Formulary - Antimicrobial 2023 (ivermectin monograph), Pregnancy and Lactation section · Egyptian National Drug Formulary - Antimicrobial 2023 (benzyl benzoate monograph)", "review_status": "reviewed", "verified_against": "CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Scabies - Recommended Regimens and Special Considerations, with the dose from MSF Essential Drugs 2024, IVERMECTIN oral: ordinary scabies row: \"Child over 15 kg and adult: 200 micrograms/kg single dose. A single dose may be sufficient\", with a second dose one week later to reduce the risk of treatment failure. MSF puts that second dose at one week against the 14 days given here, which follows the CDC guideline, and MSF states the same 15 kg floor. · CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Scabies - Recommended Regimens and Special Considerations · Permethrin 5% w/w Cream SmPC section 4.2 Posology and method of administration (eMC product 15508) · Egyptian National Drug Formulary - Antimicrobial 2023 (ivermectin monograph), Pregnancy and Lactation section", "verified_date": "2026-08", "treatments": [ { "id": 1629, "generic": "Permethrin", "line": 1, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply 5% cream over the whole body from the neck down, including neck, palms and soles, and wash off after 8-14 hours; repeat 7-14 days after the first treatment. Up to 30 g (one 30 g tube) per application", "adult_duration": "2 applications separated by 7-14 days", "dose_source": "Permethrin 5% w/w Cream SmPC section 4.2 Posology and method of administration (eMC product 15508)", "rationale": "Gold standard topical scabicide with high cure rate", "cautions": [ "Treat all household and close contacts simultaneously.", "Wash bed linen and clothing in hot water (>50C).", "Pruritus may persist for 2-4 weeks post-treatment (does not mean failure)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Where to apply splits at 2 YEARS, not at the minimum age of use. Under 2 years: whole body including face, ears and scalp, sparing the skin around the mouth and the eyes. Over 2 years: whole body including neck, palms and soles - the head and face can be spared unless there are lesions there. Amount: 2 months-5 years up to 7.5 g, 6-12 years up to 15 g. Repeat 7-14 days at every age. Licensed from 2 months, but 2-23 months only under close medical supervision. Patients over 65 should have the face, ears and scalp treated as well.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "2 to 23 months", "age_min_months": 2, "age_max_months": 23, "dose_text": "Whole body including face, ears and scalp, sparing the skin around the mouth and the eyes. Up to 7.5 g. Only under close medical supervision at this age. Repeat in 7 to 14 days." }, { "label": "2 to 5 years", "age_min_months": 24, "age_max_months": 71, "dose_text": "Whole body including neck, palms and soles; the head and face can be spared unless there are lesions there. Up to 7.5 g. Repeat in 7 to 14 days." }, { "label": "6 to 12 years", "age_min_months": 72, "age_max_months": 155, "dose_text": "Whole body including neck, palms and soles; the head and face can be spared unless there are lesions there. Up to 15 g. Repeat in 7 to 14 days." } ], "peds_doses": null, "brands": [ { "trade_name": "ECTOMETHRIN 2.5 % CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR > APC (ARAB PERFUMES CHEMICALS AND PHARMACEUTICAL CO.)", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ECTOMETHRIN 5 % CREAM. 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR > APC (ARAB PERFUMES CHEMICALS AND PHARMACEUTICAL CO.)", "price_egp": 21.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ECTOMETHRIN 5% OINT. 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR > APC (ARAB PERFUMES CHEMICALS AND PHARMACEUTICAL CO.)", "price_egp": 21.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NEWCID 1% 60ML SHAMPOO", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 9.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NEWCID 1% 80ML SHAMPOO", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 11.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "scabies" }, { "id": 1630, "generic": "Ivermectin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 6.0, "adult_dose": "200 mcg/kg as a single oral dose taken with water; repeat in 14 days", "adult_duration": "2 doses separated by 14 days", "dose_source": "CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Scabies - Recommended Regimens and Special Considerations, with the dose from MSF Essential Drugs 2024, IVERMECTIN oral: ordinary scabies row: \"Child over 15 kg and adult: 200 micrograms/kg single dose. A single dose may be sufficient\", with a second dose one week later to reduce the risk of treatment failure. MSF puts that second dose at one week against the 14 days given here, which follows the CDC guideline, and MSF states the same 15 kg floor.", "rationale": "Oral scabicide for crusted scabies, outbreaks, or topical treatment failure", "cautions": [ "Pregnancy and breastfeeding: not a contraindication. CDC 2021 states ivermectin \"likely poses a low risk to pregnant women and is likely compatible with breastfeeding; however, because of limited data ... permethrin is the preferred treatment\"; the Egyptian formulary agrees that \"use in pregnancy is likely low risk\" while other agents are recommended first.", "Children under 15 kg: CDC 2021 states the safety of ivermectin \"for children weighing <15 kg has not been determined\" and that infants and young children should be treated with permethrin.", "Take on an empty stomach with water.", "Repeat dose in 7-14 days is essential for complete eradication." ], "peds_mgkg_low": 0.2, "peds_mgkg_high": 0.2, "peds_max_mg": 15.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "200 mcg/kg (=0.2 mg/kg) single dose; safety not established in children < 15 kg", "peds_min_weight_kg": 15.0, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 20, "low_mg": 4, "high_mg": 4, "capped": false }, { "weight_kg": 30, "low_mg": 6, "high_mg": 6, "capped": false }, { "weight_kg": 40, "low_mg": 8, "high_mg": 8, "capped": false } ], "brands": [ { "trade_name": "IVACTIN 6MG 6 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 13.5, "pack_count": 6, "unit_price": 2.25, "strength_mg": 6.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IVERZINE 6MG 24 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 84.0, "pack_count": 24, "unit_price": 3.5, "strength_mg": 6.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "scabies" }, { "id": 1631, "generic": "Benzyl benzoate", "line": 2, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply the 25% lotion at night after bathing, over the whole body from the neck down; let it dry, apply a second coat, and wash it off the next morning. It may be repeated after 24 hours.", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (benzyl benzoate monograph) - verbatim: \"Scabies: Topical: After bathing, apply to moist skin and allow to dry, then reapply. Apply at night; bathe and remove the drug the next morning. May repeat application in 24 hours if necessary.\"", "rationale": "The card offers permethrin or oral ivermectin only. Benzyl benzoate is the cheap, everywhere-stocked Egyptian scabicide and the article calls it acceptable in pregnancy and in children, which is where permethrin cost or supply most often bites.", "cautions": [ "Do not put it on wounds, burns, broken skin, the face, the eyes or mucous membranes.", "It stings and burns on application and can cause a contact dermatitis that patients mistake for treatment failure.", "Dilute it for infants and children, and for elderly patients (1 part lotion with 3 parts water).", "Wash all bedding and clothing between and after applications, and treat the whole household at the same time." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Same application as adults, but the formulary says to dilute the lotion first: infants, 1 part lotion with 3 parts water; children, 1 part with 1 to 3 parts water.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "BENZYL BENZOATE 20% CREAM 40 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 3.9, "pack_count": null, "unit_price": null, "strength_mg": 40000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "scabies" } ] }