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Skin Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Christopher Bunker, Richard Watchorn
Treatment is with topical permethrin application over the entire skin overnight, repeated 7–10 days later. Clothing (including bedclothes) is washed concurrently. Oral ivermectin is an alternative.
Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Permethrin is a scabicide used topically as a cream (4 percent). Approximately 2 percent of the topical dose is absorbed systemically. According to the manufacturer, animal teratology studies did not indicate teratogenic potential. Of 106 pregnant women exposed to permethrin in the first trimester, and there was no increased frequency of congenital anomalies (Kennedy et al., 2005). Among 185 infants exposed during the first trimester of pregnancy, the frequency of birth defects was not increased (Mytton et al., 2007). Permethrin is considered the first-line agent for topical treatment of parasitic infections. It is an FDA category B drug.
Candida and parasitic infection: Helminths, trichomoniasis, lice, scabies, and malaria
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Pediculosis capitis during pregnancy follows a similar course to nonpregnant adults so treatment prior to delivery is not required, but there is typically a desire to treat due to the itching and psychologic distress of carrying a parasite in a visible location. Permethrin is the drug of choice for treatment in pregnancy and breastfeeding due to the low systemic absorption (<2% of the applied dose) and rapid clearance (53). There was no teratogenicity noted in animal studies of permethrin and there are no controlled human trials so it is a pregnancy category B drug. Observational reviews of use in humans have not identified any increased risk of adverse pregnancy outcomes (53). Permethrin use is considered to be compatible with use during breastfeeding due to the very low levels found in breastmilk. Malathion is also a pregnancy category B drug, but is typically not used in pregnancy or breastfeeding. Lindane and benzyl alcohol have been associated with abnormal neurodevelopment in animal teratogenicity studies (pregnancy category C) so should not be used in pregnancy unless absolutely necessary.
‘Loss of efficacy of topical 5% permethrin for treating scabies: an Austrian single-center study’
Published in Journal of Dermatological Treatment, 2022
Damian Meyersburg, Andreas Kaiser, Johann Wolfgang Bauer
The results of our single-center, controlled, randomized, sponsor-free study revealed following results: Two applications of permethrin with a 1-week interval were found to be as less effective as an intensive therapeutic scheme in which affected parts of the body, namely hands and/or feet and/or genitals, were treated additionally daily for 7 days (each 31%). However, at least, both schemes had an impact on mite density and itching intensity. Moreover, a repetition of the treatment with the intensive therapeutic scheme after the failure of a conventional therapy (evaluated at 3-weeks follow-up) was not associated with a better outcome (11% additional responder). In our opinion, a misuse of topical permethrin does not play a role in our patients cohort as (i) permethrin cream had been used (as a standard of care) for over 10 years and has proven efficacy even when applied only once (ii) the amount of consumed cream and accuracy of application was inquired at follow-up questionnaire, (iii) group C patients were on treatment for two ‘proximately’ courses (week 1: conventional scheme; week 4: intensive scheme), a period most likely forgiving misuse of application
The progressive alteration of urine metabolomic profiles of rats following long-term and low-dose exposure to permethrin
Published in Biomarkers, 2020
Yu-Jie Liang, Pan Wang, Ding-Xin Long, Hui-Ping Wang, Ying-Jian Sun, Yi-Jun Wu
Pyrethroid insecticides are extensively used in agriculture and public health to control pest insects because of their selective toxicity for insects and relatively low acute toxicity to mammals (Casida and Quistad 1998, Prasanthi and Rajini 2005). However, recent studies show that the insecticides are not completely harmless to human health (Nicolopoulou-Stamati et al. 2016, Chrustek et al. 2018). Permethrin, one of the pyrethroid insecticides, is mainly used for household pest control and malaria eradication (Lawrence and Casida 1983, Soderlund et al. 2002, Bradberry et al. 2005). It can cause a distinct, albeit temporary decrease in the activity of voltage-gated sodium channels in nervous system (Lawrence and Casida 1982, Michelangeli 1990, Vais et al. 2001, DeMicco et al. 2010). Its wide application makes it an increasing risk for human health (Morgan et al. 2007).
Formaldehyde as an alternative to antibiotics for treatment of refractory impetigo and other infectious skin diseases
Published in Expert Review of Anti-infective Therapy, 2019
Philip Nikolic, Poonam Mudgil, John Whitehall
Permethrin is a synthetic pyrethroid used in the treatment of scabies infections [6]. It targets the voltage-sensitive sodium channels of the mites, inactivating them causing prolonged depolarization, paralysis and death [7]. While the effect of permethrin on insects is well characterized, the literature does not contain any mention of any antibacterial properties of permethrin and so our lab worked to identify if it was capable of targeting bacteria. For this, strains of methicillin-resistant S. aureus and methicillin-sensitive S. aureus were grown in the presence of a range of concentrations of permethrin. The degree of growth inhibition was determined using viable counts. After conducting these experiments and finding no inhibition in bacterial growth, our attention turned to another component of the 5% permethrin cream – the 0.3% formaldehyde preservative. Combination inhibition experiments were then conducted using the same strains in the presence of 5% permethrin and 0.3% formaldehyde together as well as individually. In these combination experiments, 0.3% formaldehyde was capable of completely inhibiting bacterial growth regardless of the presence of permethrin. Furthermore, the inability of 5% permethrin to inhibit bacterial growth was reinforced. It is, therefore, most likely that the antibacterial activity observed in Whitehall et al. [5] was a result of the formaldehyde preservative and not the permethrin itself.