Management of Scabies in Children Weighing Less Than 15 kg and Pregnant or Breastfeeding Women

Scabies is a growing public health issue worldwide and a neglected tropical disease as defined by the World Health Organization (WHO). Young children are the most susceptible to scabies. Questions concerning safety, tolerance and formulation persist in young children weighing under 15 kg and in pregnant or breastfeeding women. The Centre of Evidence of the French Society of Dermatology (CED) therefore undertook to formulate specific recommendations, using a strict methodology. A 17-member working group (WG) was created, including dermatologists, infectious disease paediatricians, gynaecologists, parasitologists, pharmaco-toxicologists and methodologists. Its members declared no conflicts of interest. A systematic review of the literature was first conducted to compile references including any therapeutic, drug safety and cluster management studies on scabies with children under 15 kg (or, if weight was unspecified, we considered children under 5 years of age by default) and pregnant or breastfeeding women. The WG analysed the studies (at least 2 independently for each question) by describing the effect of estimates, biases and harms, then graded their level of evidence from A (several multi-centric double-blind studies with concordant positive results and acceptable risks) to D (no direct research evidence) after reaching a consensus. We used the AGREE-2 gird.