Aumento do consumo de ivermectina no Brasil e o risco de surtos de escabiose
Palavras-chave:
Ivermectina; Escabiose; Resistência a medicamentos.Resumo
Após o início da pandemia causada pelo SARS-CoV-2, a ivermectina foi identificada como um fármaco com potencial antiviral para tratamento de pacientes - a princípio hospitalizados e depois ambulatoriais - com COVID-19. No entanto, a ivermectina pode estar relacionada a mecanismos de desenvolvimento de resistência de parasitas como o Sarcoptes scabiei. Embora o consumo deste antiparasitário tenha aumentado quase 10 vezes no Brasil, curvas de contaminação e morte relacionadas à COVID-19 não se alteraram. Pareceres do Ministério da Saúde do Brasil e da indústria farmacêutica, somados a evidências científicas pouco favoráveis ao uso ambulatorial da ivermectina não foram capazes de impedir a prescrição e automedicação baseada neste medicamento. Em adição, fatores como evidências de resistência do Sarcoptes scabiei à ivermectina e intensificação de fatores relacionados à incidência de escabiose como pobreza, baixa escolarização, confinamento familiar e aumento de compartilhamento de artigos domésticos podem levar à manifestação de surtos de escabiose. Este aumento pode ser especialmente danoso para pacientes pediátricos de baixa renda, além dos riscos à saúde da população em geral. O risco de aumento da resistência à ivermectina se soma ao cenário ora apresentado, sendo um alerta para que medidas de controle de seu uso e monitoramento deste medicamento sejam discutidas e implementadas.
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