Each time the drug was taken without proper indication, it bred resistance.
Em Pernambuco, um surto de lesões cutâneas que afeta mais de 400 pessoas em 12 municípios levanta uma questão perturbadora: o remédio tomado para combater uma doença pode ter criado outra, mais resistente. Pesquisadores da Universidade Federal de Alagoas sugerem que o uso indiscriminado de ivermectina durante a pandemia de COVID-19 — um medicamento sem eficácia comprovada contra o vírus — pode ter gerado pressão seletiva sobre o ácaro da escabiose, tornando-o resistente ao próprio fármaco usado para eliminá-lo. O caso ainda aguarda confirmação, mas já aponta para uma verdade mais ampla: quando a ciência é substituída pelo medo, as consequências podem ser mais duradouras do que a doença que se tentava evitar.
- Mais de 400 pessoas em 12 municípios pernambucanos acordam com coceira intensa e lesões na pele sem explicação imediata — o surto é real, mas sua causa ainda não está confirmada.
- Pesquisadores levantam uma hipótese alarmante: o consumo irracional de ivermectina nos chamados 'kits COVID' pode ter criado ácaros resistentes ao medicamento, transformando uma infecção tratável em algo potencialmente intratável.
- Em Recife, os 176 casos se concentram nos bairros de Guabiraba e Dois Irmãos, mas a doença já apareceu em 35 bairros da capital e em cidades como Camaragibe, Jaboatão dos Guararapes e Olinda — sugerindo exposição ampla e dispersa.
- Autoridades de saúde estaduais mobilizam equipes clínicas, epidemiológicas e laboratoriais para investigar a origem do surto, enquanto orientam a população a não se automedicar.
- Se a hipótese for confirmada, o caso se tornará um exemplo concreto de como o mau uso de antiparasitários pode gerar resistência com consequências globais — o mesmo fenômeno já documentado com bactérias e antibióticos.
Nos bairros de Guabiraba e Dois Irmãos, no norte do Recife, pessoas começaram a aparecer com lesões na pele que coçavam sem parar. Até meados de novembro de 2021, as autoridades de saúde já contabilizavam 176 casos na capital e cerca de 250 em outros onze municípios do estado. O surto era inegável. A causa, porém, permanecia em aberto — até que pesquisadores da Universidade Federal de Alagoas apresentaram uma hipótese inquietante.
O problema, segundo eles, não seria um patógeno novo, mas um antigo tornado perigoso pelo mau uso de um medicamento comum. A ivermectina, antiparasitário sem eficácia comprovada contra a COVID-19, havia se tornado item obrigatório nos chamados kits COVID distribuídos por médicos e planos de saúde no Brasil. Com o consumo em alta, os pesquisadores Sabrina Neves, Alfredo Oliveira-Filho e seus colaboradores teorizam que o ácaro causador da escabiose pode ter desenvolvido resistência ao fármaco. Se confirmado, o surto deixaria de ser um episódio localizado para se tornar um sinal de alerta: uma infecção resistente ao tratamento disponível, capaz de atingir qualquer população.
Sabrina Neves foi direta ao nomear o problema central: não é o medicamento em si, mas o modo como foi usado. Cada dose tomada sem indicação correta ou em dosagem inadequada cria pressão seletiva sobre o parasita, favorecendo cepas resistentes. Ela lembrou que a resistência antimicrobiana — bacteriana, parasitária ou fúngica — já é uma crise global. O uso irracional de ivermectina em uma região poderia, portanto, gerar consequências que ultrapassam suas fronteiras.
A geografia do surto reforçava a preocupação. Além dos casos em Recife, municípios como Camaragibe (108 casos), Jaboatão dos Guararapes (60) e Olinda (22) também registravam ocorrências, num padrão disperso compatível com um parasita que se tornou ao mesmo tempo comum e resistente. As autoridades estaduais investigavam, orientando a população a buscar atendimento médico e evitar a automedicação. Enquanto isso, mais de 400 pessoas aguardavam respostas — e continuavam a coçar.
In the neighborhoods of Guabiraba and Dois Irmãos in Recife's north side, something was spreading fast. People were showing up with skin lesions that itched relentlessly, and no one could quite explain why. By mid-November 2021, the state health authorities had logged 176 cases in the capital alone, with another 250 or so scattered across eleven surrounding municipalities. The outbreak was real enough to trigger investigations. What caused it remained a mystery—until researchers at the Federal University of Alagoas offered a troubling hypothesis.
The culprit, they suggested, was not a new pathogen but an old one rendered newly dangerous by misuse of a common drug. Ivermectin, an antiparasitic medication that had been proven useless against COVID-19, had nonetheless become a fixture in the so-called COVID kits that doctors and health plans were prescribing across Brazil during the pandemic. The drug's popularity soared. And as consumption climbed, the researchers theorized, the mite that causes scabies—a parasitic skin infection known medically as escabiosis—may have developed resistance to the very medicine meant to kill it. If that hypothesis held, the outbreak represented something far more serious than a temporary inconvenience: it suggested the emergence of a treatment-resistant infection that could spread to anyone, anywhere, and prove far harder to cure.
The study, released by the university's Institute of Pharmaceutical Sciences on a Friday in late November, was authored by researchers Sabrina Neves and Alfredo Oliveira-Filho, along with students Lucas Bezerra and Natália Alves. They had observed something troubling in the literature: isolated cases of ivermectin resistance had already been documented. They had watched the consumption data climb during the pandemic. And now they were watching cases of unexplained skin lesions multiply across a region. The pieces seemed to fit, even if the final picture remained incomplete.
Sabrina Neves, speaking from the institute, framed the problem in stark terms. An outbreak was indeed underway—the rapid accumulation of cases with itching and skin damage made that clear. If the scabies mite had truly become resistant to ivermectin, the consequences would be severe. The disease could reach any population, and treatment would become difficult or impossible. The real issue, she emphasized, was not the drug itself but how it had been used. Irrational medication use is a public health crisis, she said, but when it involves antiparasitic drugs, the stakes climb higher. Each time ivermectin was taken without proper indication or in incorrect doses, it created selective pressure on the parasite, breeding resistance. That resistance, once established, could spread to anyone.
Neves pointed to a broader pattern. Antimicrobial resistance—whether bacterial, parasitic, or fungal—is a global crisis. Bacteria resistant to antibiotics now circulate worldwide. If the same dynamic was now playing out with scabies mites and ivermectin, it would represent a failure not just of individual prescribing practices but of public health communication. A drug taken irrationally in one region could create resistant strains that threaten populations everywhere.
The outbreak's geography told its own story. Most of Recife's 176 cases clustered in the northern neighborhoods of Guabiraba and Dois Irmãos, though the disease had appeared in thirty-five neighborhoods across the city—from Boa Viagem in the south to Afogados in the west. Beyond Recife, cases had surfaced in Camaragibe (108 cases), Jaboatão dos Guararapes (60), Olinda (22), and smaller numbers in towns stretching from the coast inland to Nazaré da Mata. The pattern suggested not a single point source but rather widespread exposure, consistent with a parasite that had become common and resistant.
State health authorities acknowledged the outbreak was under investigation. Clinical, epidemiological, and laboratory teams from the state health secretariat, the central laboratory, and specialist consultants were working to determine the cause. Until they did, the official guidance was clear: seek medical help, do not self-medicate. But the researchers' hypothesis hung in the air. If confirmed, it would mean that the very effort to treat a viral illness with an ineffective drug had inadvertently created conditions for a parasitic disease to become untreatable. The investigation would need to prove or disprove that chain of causation. Until then, more than four hundred people across twelve municipalities would continue to itch, waiting for answers.
Citações Notáveis
If this hypothesis is confirmed, we have an enormous problem, because the disease could reach any population, and worse, with difficulty in treatment.— Sabrina Neves, researcher at the Institute of Pharmaceutical Sciences
Irrational use of medications is a public health problem, but with antiparasitic drugs, the problem takes on larger proportions.— Sabrina Neves
A Conversa do Hearth Outra perspectiva sobre a história
Why would a drug that doesn't work against COVID-19 become so widely used in the first place?
Because during the pandemic, there was enormous pressure to do something, anything. Doctors wanted to help, patients wanted hope, and the drug was cheap and available. No one was stopping people from taking it.
And the connection to scabies resistance—how certain are the researchers about that?
Not certain at all. They're raising a hypothesis based on the timing and the data. The outbreak is real. Ivermectin overuse is real. But they haven't yet proven the mite is actually resistant. That's why the investigation is ongoing.
If it is resistant, what happens to people who get infected?
Treatment becomes much harder. Scabies is treatable, but if the standard drug no longer works, doctors have to use alternatives that may be less effective, more expensive, or have worse side effects. And the disease keeps spreading.
Is this a problem unique to Brazil?
No. The researchers mention this is a global issue, especially with bacteria and antibiotics. But what makes this case notable is how quickly it could have happened—driven by a specific public health decision during a crisis.
Who gets hit hardest by an outbreak like this?
The data shows it's concentrated in certain neighborhoods in Recife's north side. These tend to be lower-income areas with less access to healthcare. If the disease becomes resistant and treatment fails, those communities suffer most.
What should have happened differently?
Better communication about what ivermectin actually does and doesn't do. Stricter prescribing guidelines. Public health authorities being clear that an unproven treatment is not the same as a helpful one. The drug itself isn't the problem—how it was used is.