OBJECTIVE: To optimize the permethrin-based therapies for scabies infestations in infants and young children the efficacies of three different regimens were evaluated.

STUDY DESIGN: The retrospective analysis encompassed 85 infants and children aged <4 years with scabies. The children had received either topical permethrin 5% on the entire body on days 1/8 (I), on days 1/8/15 (II), on days 1/8/15 plus interim applications restricted to hands and feet on days 2/3/4//9/10/11 (III), or alternative treatments (IV).

RESULTS: The intensified regimen, consisting of full-body permethrin applied on days 1/8/15 and hands/feet on days 2/3/4//9/10/11, resulted in cure of scabies in 73.5% of the cases. The cure rates were significantly higher compared with full-body permethrin given on days 1/8, which led to eradication in 44%, and were higher compared with the clearance in children who had received full-body permethrin on days 1/8/15 (53.8%) or alternative treatments (60%). For patients in whom permethrin had previously been applied, the intensified regimen resulted in eradication of scabies in 71.4% of the cases, compared with 30% and 55.6% after full-body permethrin on days 1/8 and 1/8/15, respectively.

CONCLUSIONS: The intensified regimen of full-body permethrin plus interim applications on hands/feet, which aims at reducing the number of mites present on the frequently heavily-infested palmoplantar sites in addition to the standard entire body application, appears efficacious in curing scabies in young children.