Scabies

Patients should be checked 4 weeks after initiation of treatment to be sure that treatment was successful. If there is evidence of continued infestation, a careful history of treatment regimen for the patient and contacts should be obtained to determine if this is due to resistance to the agents used, improper administration of treatment, or reinfestation due to inadequate treatment of close contacts. If resistance is suspected, another agent should be used. If inadequate topical treatment of the patient or contacts is suspected, instructions should be carefully reviewed. Consideration should also be given to the use of ivermectin because the single oral dose usually results in higher compliance than is seen with topical medicines.