Latar belakang: Skabies adalah penyakit kulit akibat infestasi ektoparasit berupa tungauSarcoptes scabiei var hominis. Skabies menimbulkan ketidaknyamanan karenamenimbulkan lesi yang sangat gatal, menyebabkan penderita sering menggaruk danmengakibatkan infeksi sekunder terutama oleh Streptococcus pyogenes danStaphylococcus aureus. Prinsip tata laksana skabies impetigenisata meliputi penggunaanskabisid dan antibiotik untuk pasien dan narakontak. Sediaan permetrin merupakan pilihanutama, dengan antibiotik sistemik atau topikal untuk infeksi sekunder bakterial. AsamFusidat 2% merupakan antibiotik topikal pilihan pertama yang dianjurkan untuk lesi infeksiterbatas. Sampai saat ini belum ada penelitian mengenai efektivitas kombinasi krimpermetrin 5% dan krim asam fusidat 2% untuk skabies impetigenisata.Tujuan: Membandingkan efektifitas kombinasi krim permetrin 5% dan krim asam fusidat2% dengan krim permetrin 5% dan plasebo; membandingkan skor VAS nyeri, Vas gataldan efek samping sebelum dan sesudah pengobatan pada kedua kelompok; melihat petakuman dan biakan dari skabies impetigenisataMetode: Sebuah uji klinis acak tersamar ganda dilakukan di Pondok Pesantren Al Islami,Cibinong, Bogor dan Pondok Pesantren Gaza Al-Islami Bogor pada September hinggaOktober 2018 dan Maret 2020. Terdapat 41 orang santri yang memenuhi kriteria penelitian,tetapi hanya 40 subjek penelitian (SP) menyelesaikan penelitian. Alokasi kelompokdilakukan secara acak mengikuti tabel randomisasi. Kelompok intervensi mendapatkankrim permetrin 5% dan krim asam fusidat 2%, sedangkan kelompok kontrol mendapatkankrim permetrin 5% dan plasebo. Dilakukan pemeriksaan kerokan kulit, apusan Gram,biakan, skor VAS gatal dan VAS nyeri. Subjek penelitian kemudian di follow-up pada harike-7 dan ke-14 untuk menilai kesembuhan, skor VAS gatal, VAS nyeri dan efek sampingpengobatan.Hasil: Efektivitas kesembuhan kelompok intervensi pada hari ke-7 lebih tinggi dibandingkelompok kontrol (80% vs. 35%). Efektivitas kesembuhan kelompok intervensi pada harike-14 lebih tinggi dibanding kelompok kontrol (95% vs. 35%) yang bemakna secarastatistik (p=<0.001) dan relative risk hari ke-14 adalah 2,714. Terdapat perbedaanbermakna median selisih skor VAS gatal pada kelompok intervensi dibandingkankelompok kontrol setelah pengobatan (p=0,040) dan median selisih skor VAS nyeri(p=0,035). Bakteri tersering ditemukan adalah Staphylococcus aureus diikuti denganbakteri Gram-negatif.Tidak terdapat perbedaan efek samping bermakna pada keduakelompok.Kesimpulan: Pengobatan skabies impetigenisata dengan krim pemetrin 5% dan krim asamfusidat 2% lebih efektif dibandingkan krim permetrin 5% dan plasebo. Perbaikan skor VASnyeri dan Vas Gatal dan tidak terdapat efek samping. Bakteri tersering merupakanStaphylococcus aureus diikuti dengan bakteri Gram-negatif.

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Background: Scabies is a skin disease due to ectoparasitic infestation in the form of

Sarcoptes scabiei var hominis. Scabies causes discomfort, and it causes very itchy lesions,

causing patients to often scratch and result in secondary bacterial infections, especially by

Streptococcus pyogenes and Staphylococcus aureus. The principles of management of

impetiginized scabies include the use of scabicidal and antibiotics for patients and

surrounding people. Permethrin 5% is the first-line treatment, combined with systemic or

topical antibiotics for secondary bacterial infections. Fusidic Acid 2% is the first-line

topical antibiotic recommended for limited infection. There has been no research on the

effectiveness of a combination of permethrin 5% cream and fusidic acid 2% cream for the

treatment of impetiginized scabies

Objectives: Comparing the effectiveness of a combination permethrin 5% cream and

fusidic acid 2% cream with 5% permethrin cream and placebo; comparing VAS pain and

VAS itchy scores, side effects before and after treatment in both groups; Displaying the

germs map of germs and cultures of impetiginized scabies

Methods: A double-blind, randomized clinical trial was carried out at Al-Islamic Boarding

School at Cibinong Bogor and Gaza Al-Islamic Boarding School at Bogor in September to

October 2018 and March 2020. Forty-one students met the study criteria, but only 40

research subjects complete research. Group allocations are carried out randomly following

a randomization table. The intervention group received permethrin 5% cream and fusidic

acid 2% cream, while the control group received permethrin 5% cream and placebo. Skin

scrapings, Gram smears, and cultures were examined. VAS itch and pain were also

examined. The study subjects were followed up on days 7 and 14 to assess healing, VAS

itch and pain, and side effects of treatment.

Results: Healing effectiveness of the intervention group on day 7 was higher than in the

control group (80% vs. 35%). The effectiveness of the intervention group healing on the

14th day was higher than the control group (95% vs. 35%), which was statistically

significant (p = <0.001), and the relative risk of the 14th day was 2,714. There was a

significant difference in median difference in itching VAS score in the intervention group

compared to the control group after treatment (p = 0.040) and median difference in pain

VAS score (p = 0.035). The most common bacterium found was Staphylococcus aureus

followed by Gram-negative bacteria. There were no significant differences in side effects

in the two groups.

Conclusion: The treatment of impetiginized scabies with permethrin 5% cream and fusidic

acid 2% cream is more effective than permethrin 5% cream and placebo. Improved VAS

score for pain and itch with no side effects. The most common bacterium is Staphylococcus

aureus followed by Gram-negative bacteria.