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Letter to the Editor
Comment on “Epidemic Scabies: New Treatment Challenges in an Ancient Disease”
Comentario a «Epidemia de escabiosis: los nuevos retos de una enfermedad ancestral»
Ó. Suárez-Amora,
Autor para correspondencia
osuamo@yahoo.es

Corresponding author.
, B. Monteagudob, M. Cabanillasa
a Dermatología, Hospital Ribera Juan Cardona, Ferrol, Spain
b Servicio de Dermatología, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the article by Lluch-Galcer&#225; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a> on the current scabies epidemic&#46; First&#44; we would like to commend the authors on their excellent review of this topic&#46; We would also like to add a small point and clarify a controversial issue regarding the use of oral ivermectin&#44; which we think stems from a section of the summary of product characteristics that currently states &#8220;the influence of food on absorption is unknown&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The bioavailability of ivermectin is increased by the intake of food&#44; particularly fatty food&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">3</span></a> What differs in the studies published to date is the intensity of the effect&#44; which ranges from zero to a 2&#46;6-fold increase&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">4</span></a> The discrepancies could be linked to the different doses of ivermectin used in the respective studies&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In their article&#44; Lluch-Galcer&#225; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a> indicate that ivermectin should be taken after fasting&#44; and this is indeed stipulated in several guidelines&#44; including the German guidelines on the diagnosis and treatment of scabies&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> Most authors&#44; however&#44; believe that ivermectin should be taken with fatty foods to increase its absorption and potential effectiveness&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">6&#44;7</span></a> The Centers for Disease Control and Prevention<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a> and the European Academy of Dermatology and Venereology both specifically recommend taking ivermectin with food&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">No funding of any type was received for this article&#46;</p></span></span>"
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