Abstract
In Aboriginal populations, group A streptococci are still the predominant pathogens in skin infections (pyoderma/impetigo/skin sores). A lack of water and overcrowding contribute to skin sore development, and the resolution of these environmental hazards should have the greatest and most sustainable impact on the burden of skin disease. Single-dose intramuscular (IM) benzathine penicillin remains the treatment of choice for pyoderma. Much of the streptococcal pyoderma is secondary to scabies and the control of scabies infestations, which are also a feature of overcrowding, can significantly reduce skin infections. Coordinated mass treatment with 5%permethrin cream has resulted in significant medium-term reductions in both scabies and pyoderma. Single-dose ivermectin as a scabicide is also effective and safe in children over the age of 5 years. Identifying and treating people with scabies hyperinfestation (crusted/Norwegian scabies) is important to prevent ongoing scabies epidemics. There is little evidence of benefit to human disease in treating community dogs for scabietic mange. The burden of fungal infections in Aboriginal communities in the tropics also contributes to streptococcal pyoderma and oral terbinafine is significantly more efficacious than older therapies.
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Publication Name
Aboriginal Primary Health Care: an evidence-based approach
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ISBN/ISSN
978-0-19-555138-9
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Pages Count
35
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Publisher
Oxford University Press
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Publisher Location
South Melbourne, VIC, Australia
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