Pediatric Nursing Q 163
A 1-year-old child is diagnosed with scabies. Which of the following medicines is expected to be prescribed?
A. Permethrin
B. Lindane
C. Both
D. None
Correct Answer: A. Permethrin
Permethrin and Lindane are used against scabies, but lindane is contraindicated for children below two years old because of the risk of seizures and neurotoxicity. Topical permethrin 5% cream is effective and widely used. The cream is typically applied once a week for two weeks (a total of 2 treatments). However, this treatment is occasionally associated with scabies resistance, poor patient compliance, and rare allergic reactions.
Option B: Other options are topical lindane, 5% precipitated sulfur, malathion, and topical ivermectin. Lindane Lotion is contraindicated for premature infants because their skin may be more permeable than that of full-term infants and their liver enzymes may not be sufficiently developed to metabolize Lindane.
Option C: Permethrin has not been approved by the FDA for use in infants before the age of 2 months, and limited studies have taken place to assess the use of this medication in these patients. However, some recent research suggests that 5% permethrin cream can be safely used to treat scabies in this infant population.
Option D: For classical scabies, 5% permethrin cream is applied topically to cool, dry skin from the patient’s head to the patient’s toes and under the fingernails. The cream is washed off after 8 to 14 hours and is often reapplied in the same way one week later.