Guideline for managing ectoparasitic infestations (scabies and pediculosis) in the context of pharmaceutical care.

Abstract

Objective: To systematize, through evidence-based practice, the management of self-limited cases of ectoparasitic infestations in the context of Pharmaceutical Care. Methods: To prepare the guideline, the ADAPTE method was adopted as a structured process of literature review and document construction. The AGREE II and GRADE tools were also used to analyze the practice guides selected during the process and to categorize the evidence, respectively. Results: The anamnesis is a fundamental step in the intervention strategy and confirmation of the self-limiting nature of ectoparasitoses, analyzing the location and characteristics of the problem, and referring for suspected secondary infections. Non-pharmacological interventions are limited to more traditional practices for reducing infestation, such as mechanical removal methods in pediculosis and decontamination measures and health education in scabies. Regarding pharmacological measures, there are few available options with benefits and restrictions according to the patient's profile, with the prioritization of topical formulations of creams or lotions based on permethrin and oral ivermectin as the first-line treatment. The pharmacist must be attentive to monitor the appearance of warning signs for referral, such as medication sensitivity, signs of infections with secretions, immunocompromised patients, and elderly individuals more vulnerable to the development of crusted scabies.