Increased use of ivermectin in Brazil and the risk of scabies outbreaks
Keywords:Ivermectin; Scabies; Drug resistance.
Following the onset of the pandemic caused by SARS-CoV-2, ivermectin was identified as a drug with antiviral potential for treating patients - initially hospitalized and then outpatients - with COVID-19. However, ivermectin may be related to resistance development mechanisms of parasites such as Sarcoptes scabiei. Although the consumption of this antiparasitic has increased nearly 10 times in Brazil, the contamination and death curves related to COVID-19 did not change. Judgments from the Brazilian Ministry of Health and the pharmaceutical industry, added to scientific evidence unfavorable to the outpatient use of ivermectin, were not able to prevent prescription and self-medication based on this drug. Furthermore, factors such as evidence of resistance of Sarcoptes scabiei to ivermectin and intensification of factors related to the incidence of scabies such as poverty, low education, family confinement and increased sharing of household objects can lead to the outbreak of scabies waves. This increase can be especially harmful to low-income pediatric patients, as well to health risks for the general population. The risk of increased resistance to ivermectin adds to the scenario presented here, being an alert for measures to control its use and monitoring of this drug to be discussed and implemented.
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