Table 2.

An overview of classical treatments indicated for the management of scabies in Australia

Study	Drugs	Dosage	Treatment regimen	Contraindication	Disadvantages	Comments
	Topical
[55, 56]	Benzyl benzoate	25 % solution	one or several consecutive 24-h applications	pregnant women and infants	burning or stinging, pruritus, dermatitis, convulsions (rare)	In use since 1930s; possible neurological complications with misuse; withdrawn in the European Union due to neurotoxicity concerns
[23, 56–58]	Permethrin	5 % cream (8–14 h) then wash off	apply overnight	infants aged <2 months	mild burning, itching stinging, pruritus, erythema, tingling, persistent excoriation, dystonia (rare), convulsions (rare)	in use since the 1980s; relatively expensive; growing resistance among scabies mites poor compliance reported in mass community intervention programs
[59, 60]	Sulphur	2–10 % precipitate in petroleum base	apply for 24 h, and then wash and reapply repeat applications for 3 days		noxious, malodorous messy; not given as first-line agents; multiple applications required; can cause skin irritation;	has been used for centuries; indicated in infants, pregnant and lactating women; inexpensive
	Oral
[53, 61–63]	Ivermectin	200 μg/kg orally repeated after 1–2 weeks		children aged <5 years.; children <15 kg; pregnant or lactating women	transient side effects: gastrointestinal disorders; pustular rash, cellulitis; abdominal pain, diarrhoea, headache, vomiting, hypotension, toxic epidermal necrosis, mucosal drug eruption, fever, anorexia, lymph node swelling, eosinophilia, pain of joint and muscles, mazzotti reaction	in use since 1980’s (for the mass treatment of onchocerciasis, and filariasis); not approved for the treatment of typical scabies (except in Japan, Brazil, France); only indicated if symptoms persists 3 weeks after application of benzyl benzoate or permethrin; no ovicidal activity, thus repeat treatment is required; one report of increased deaths among elderly patients during scabies outbreak in an institutional setting (1997); there has been considerable criticism on the validity of this report, no other studies have replicated these findings