Romani L, et al. - Considering small community-based trials have indicated the effectiveness of mass drug administration of ivermectin in substantially lowering the prevalence of both scabies and secondary impetigo, researchers evaluated the effectiveness of this tactic with co-administration of azithromycin for trachoma in this large-scale azithromycin ivermectin mass drug administration (AIM) trial, a prospective, single-arm, before-and-after, community intervention study. Over 4 weeks in September 2015, researchers treated 26,188 people, which was 99.3% of the estimated population of Choiseul as per the 2009 census. Scabies prevalence was lowered by 88% vs 94% in SHIFT (the skin health intervention Fiji trial, the first comparative trial of mass drug administration for scabies), and impetigo prevalence was lowered substantially in both AIM and SHIFT (74% AIM vs 67% SHIFT). This suggests that ivermectin-based mass drug administration can be adapted to a population of over 25,000 with comparable efficacy as in a small island-based trial setting and that achievement of this level of effectiveness could be seen when mass drug administration for scabies is combined with azithromycin mass drug administration is done for trachoma.