Arezki Izri, M.D., Robert Hofmann, M.D., Ph.D., Stephen G. Mann, M.D., and Ian Burgess, Ph.D.
Le traitement serait efficace à 95%, soit davantage que les lotions classiques.
Mais l’ivermectine devra être réservée aux cas difficiles à traiter qui résistent aux lotions afin de ne pas créer de résistance à ce nouveau traitement.
Revoir également : LES POUX – PEDICULOSE [Lire]
Head-lice infestation is prevalent worldwide, especially in children 3 to 11 years old. Topical insecticides (i.e., pyrethroids and malathion) used as a lotion, applied twice at an interval of 7 to 11 days, are typically used for treatment. Resistance of lice to insecticides, particularly pyrethroids, results in treatment failure. The efficacy of alternative agents is controversial.
We conducted a multicenter, cluster-randomized, double-blind, double-dummy, controlled trial comparing oral ivermectin (at a dose of 400 µg per kilogram of body weight) with 0.5% malathion lotion, each given on days 1 and 8, for patients with live lice not eradicated by topical insecticide used 2 to 6 weeks before enrollment. The cluster was defined as the household. Infestation was confirmed and monitored by means of fine-toothed combing. Patients were at least 2 years of age and weighed at least 15 kg; all were treated at the study sites. The primary end point was the absence of head lice on day 15.
Ivermectine 400 µg/kg -Stromectol ® Cp à 3 mg
|POIDS CORPOREL (kg)||
(en nombre de comprimés à 3 mg)
|15 à 24||Deux|
|25 à 35||Quatre|
|36 à 50||Six|
|51 à 65||Huit|
|66 à 79||Dix|
A total of 812 patients from 376 households were randomly assigned to receive either ivermectin or malathion. In the intention-to-treat population, 95.2% of patients receiving ivermectin were lice-free on day 15, as compared with 85.0% of those receiving malathion (absolute difference, 10.2 percentage points; 95% confidence interval [CI], 4.6 to 15.7; P<0.001). In the per-protocol population, 97.1% of patients in the ivermectin group were lice-free on day 15, as compared with 89.8% of those in the malathion group (absolute difference, 7.3 percentage points; 95% CI, 2.8 to 11.8; P=0.002). There were no significant differences in the frequencies of adverse events between the two treatment groups.
For difficult-to-treat head-lice infestation, oral ivermectin, given twice at a 7-day interval, had superior efficacy as compared with topical 0.5% malathion lotion, a finding that suggests that it could be an alternative treatment.
(ClinicalTrials.gov number, NCT00819520