Public Health in Emergency MedicineIvermectin Causes Cimex lectularius (Bedbug) Morbidity and Mortality

BackgroundBedbug infestations are increasing across North America and Europe, with more people presenting to Emergency Departments for treatment. Physicians cannot provide substantive treatment for people affected by bedbugs.Study ObjectiveTo determine if ivermectin, a relatively inexpensive and safe, long-acting oral anti-parasitic drug is able to cause bedbug morbidity and mortality.MethodsWe evaluated the effects of ivermectin on bedbugs using an artificial feeding membrane and mice and humans. Bedbug morbidity, mortality, and nymph molting was recorded.ResultsUsing an artificial feeding membrane, bedbug mortality was 98% (n = 81) for 260 ng/mL ivermectin and 0% for 0 ng/mL ivermectin (control; n = 90) after 13 days. Mortality for bedbugs fed on mice injected with the human equivalent of 200 μg/kg ivermectin was 86% (n = 22), vs. 0% in the 0 μg/kg ivermectin (control; n = 21). Of the surviving nymphs, 0% exposed to ivermectin molted by day 75, vs. 80% in the control group by day 8. Bedbugs that fed once on human study subjects 3 h after consuming 200 μg/kg of oral ivermectin had a 63% (n = 24) 20-day mortality rate, vs. 8% (n = 24) in the control group. Of the surviving nymphs, 0% (n = 5) in the 3-h ivermectin group molted, vs. 80% (n = 10) of the control group.ConclusionsIt may be possible that ivermectin could help eradicate, suppress, or prevent a bedbug infestation.