Effectiveness of oral itraconazole in the management of otomycosis with tympanic membrane perforation

Ravindran, Aju; M, Sagesh

doi:10.18203/2320-6012.ijrms20171229

Cited by 5 publications

(6 citation statements)

References 6 publications

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“…Our results are inconsistent with those of other studies [ 2 , 5 , 21 , 25 ]. These differences can be due to the type of pathogenic etiological agents, anatomy of the ear, immune system status, and tympanic membrane perforation.…”

Section: Discussioncontrasting

confidence: 99%

“…In line with our findings, in a single-blind randomized clinical study, 93.3% of the cases treated with clotrimazole and lignocaine solutions demonstrated an improvement in the clinical symptoms of itching and discharge, and ear pain was recovered in 86.7% of the patients [ 20 ]. In another study, Aju and Sagesh (2017) used a combination therapy with oral itraconazole and ofloxacin ear drops for the treatment of otomycosis [ 21 ] and reported similar results.…”

Section: Discussionmentioning

confidence: 92%

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Effect of combination therapy with ceftizoxime and clotrimazole in the treatment of otomycosis

Omran¹,

Yousefzade²,

Khafri³

et al. 2018

CMM

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Background and Purpose:There are controversial findings regarding the efficacy of antifungal drugs in the treatment of a ruptured eardrum following fungal infections. Regarding this, the aim of the present study was to evaluate the therapeutic effect of the co-administration of antifungal and antibacterial agents in the treatment of otomycosis with tympanic membrane perforation.Materials and Methods: This analytical, clinical trial was conducted on 87 patients with otomycosis showing no bacterial elements in the direct observation and culture. The study population was assigned into two groups of intervention (n=45) and control (n=42). The demographic and clinical data, as well as the data related to the direct observation and culture of the ear samples were recorded in a checklist. All statistical analysis was performed in SPSS (version 24).Results:The most prevalent symptoms in both groups were hearing loss and itching, and the most common finding was secretion. Aspergillus and Candida were the most frequent fungi isolated from the samples. After the implementation of combination therapy, the intervention group demonstrated a significant decrease in symptoms and signs, compared to the control group (P=0.005).Conclusion:The findings of the present study indicated that the use combination therapy with ceftizoxime powder and clotrimazole ointment was effective the in treatment of the patients with tympanic membrane rupture showing no bacterial effects in direct examination and culture.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 92%

Effect of combination therapy with ceftizoxime and clotrimazole in the treatment of otomycosis

Omran¹,

Yousefzade²,

Khafri³

et al. 2018

CMM

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“…Other studies have also shown similar responses to clotrimazole and itraconazole in otomycosis. 24,25 Itraconazole is an effective alternative to a traditional method of treatment for otomycosis. 25 Compared to the study under discussion, different response to primary treatment was noted in several other studies.…”

Section: Discussionmentioning

confidence: 99%

A study of clinico-mycological profile and treatment of primary otomycosis

et al. 2023

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Background: Otomycosis is a superficial mycotic infection of the external auditory canal. Clinical presentation, along with otoscopic findings, is sufficient to make the diagnosis in most of the cases. Treatment includes aural cleaning followed by the instillation of anti-fungal ear drops. In the recent years, there has been an increasing trend of antifungal resistance for the commonly used antifungals such as fluconazole and clotrimazole. Drug sensitivity patterns have also shown variability from one region to another. Aims and Objectives: To evaluate the clinico-mycological profile along with antifungal susceptibility pattern and treatment outcome of primary otomycosis. Materials and Methods: A total of 230 clinically diagnosed patients of primary otomycosis were included in this prospective study. Microbiological causes were evaluated by KOH wet mount and culture of samples collected from external auditory meatus using sterile swabs. Fungal culture was done on Sabouraud dextrose agar with chloramphenicol at 25°C and 37°C. Anti-fungal susceptibility test was done by disk diffusion method using medium Muller-Hilton agar with glucose and methylene blue. All the patients were treated with the removal of fungal debris with topical clotrimazole instillation and were followed up after 7 days. Non-responders were treated with topical itraconazole. Results: Male-to-female ratio in study participants was 1:1.3. The most frequently observed risk factor was the instillation of oil in the ear (20%). Ear itching was the commonest symptom (70.9%). Positive fungal growth was seen in 203 (88.3%) cases. Aspergillus was present in 185 (91.1%) cases, followed by Candida in 18 (8.9%) cases. Voriconazole had the highest sensitivity followed by itraconazole. 167 (83.3%) patients responded to primary treatment (topical Clotrimazole), 36 (16.7%) patients were non-responders. Conclusion: All the clinically suspected patients should be evaluated for fungal positivity, which may further guide in the selection of appropriate anti-fungal agents. Awareness regarding the predisposing factors for otomycosis in the general population may result in a significant drop in the incidence of otomycosis.

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“…Controversy exists between the types of antifungal ointment to be prescribed by otorhinolaryngologists. 11 We have compared nystatin versus isoconazole in present study. There is no previous study which has particularly compared these two antifungals.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Isoconazole Nitrate Versus Nystatin for Treatment of Otomycosis

Khan

Anwar

Akram³

et al. 2021

PAFMJ

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Objective: To compare isoconazole nitrate versus nystatin for treatment of otomycosis. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Bahawalpur and Combined Military Hospital Mardan, from Jan to Dec 2018. Methodology: Total 204 cases fulfilling the inclusion criteria were selected from outpatient department of Combined Military Hospital Bahawalpur and Mardan. They were divided into 2 groups of 102 each using random number tables. Group A cases were given Isocona-zole nitrate for application in external auditory meatus and group B cases were given Nystatin. All the cases were examined two weeks later and outcome was compared in terms of clinical improvement and symptoms resolution. Results: Out of 204, 125 patients were females and rest 79 were males. Age range was from 12-87 years with mean age 31 ± 2.4. Both groups were identical in terms of gender. In group A patients, 74 (72.5%) showed marked improvement after two week, 15 (14.7%) showed moderate improvement and 13 (12.7%) showed minor improvement. However, in group B, 55 (53.9%) showed marked improvement after two week, 23 (22.5%) showed moderate improvement and 24 (23.5%) showed minor improvement. Group A treatment was found significantly better than group B treatment (p=0.021). Conclusion: Isoconazole nitrate ointment was found significantly more effective for treating otomycosis than nystatin.

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Effectiveness of oral itraconazole in the management of otomycosis with tympanic membrane perforation

Cited by 5 publications

References 6 publications

Effect of combination therapy with ceftizoxime and clotrimazole in the treatment of otomycosis

Effect of combination therapy with ceftizoxime and clotrimazole in the treatment of otomycosis

A study of clinico-mycological profile and treatment of primary otomycosis

Comparison of Isoconazole Nitrate Versus Nystatin for Treatment of Otomycosis

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