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Scabies is a parasitic infestation of the skin caused by the mite Sarcoptes scabieivar hominisa human pathogenwhich is spread by close physical contact between infected personsWhilst the majority of patients suffer from typical scabiessome patients develop crusted scabiesa severe form of scabies characterised by crusted lesions affecting the palms and solesand thickened and dystrophic nailsScabies infestation can lead to pyodermaskin sores infested with bacteriaespecially group A streptococcus or Staphylococcus aureusThese bacterial infections can cause significant morbidity and is associated with post-streptococcal glomerulonephritisAPSGNand possibly acute rheumatic feverARFrheumatic heart diseaseRHD

The PBAC considered that the restriction should state that children aged less than 5 years and/or weighing less than 15kg should be precluded from receiving ivermectin given the precaution listed in the approved Product Information and the limited safety data[1in this group.

The PBAC noted that ivermectin is not ovicidaland considered that this underlined the importance of using both doses of ivermectin to ensure complete eradicationThe PBAC considered such practice could increase the efficacy of the treatment and mitigate against the development of mite-resistance to ivermectin.

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