Efficacy of topical clotrimazole vs. topical tolnaftate in the treatment of otomycosis. A randomized controlled clinical trial

Jimenez-Garcia, Lesly; Celis‐Aguilar, Erika; Díaz-Pavón, Gaudencio; Estrada, Victor Muñoz; Castro-Urquizo, Ángel; Hernández-Castillo, Nemiliztli; Amaro-Flores, Ernesto

doi:10.1016/j.bjorl.2018.12.007

Cited by 25 publications

(26 citation statements)

References 19 publications

(32 reference statements)

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“…Because most cases of otomycosis are reported in hot and wet climate countries, a seasonal factor is thought to be involved. Many researchers have reported that summer is the commonest season, although some have favoured spring . In this study, we did not investigate the seasonal factor because in Guangzhou, a southern China region, seasonal change is not clear‐cut and the hot weather lasts nearly throughout the year.…”

Section: Discussionmentioning

confidence: 99%

“…The first step is to remove fungal secretions in the external auditory canal and then apply antifungal drugs locally. Many kinds of drugs have been reported, such as nystatin ear drops, compound resorcinol solution, fluconazole ear drops, 3% boric acid alcohol and 3%‐5% salicylic acid alcohol, as well as creams such as clotrimazole, ketoconazole and econazole whose curative effects differ . Munguia and Daniel reported that the azole antifungals were the most effective drugs for treating otomycosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, the reported cure rates of otomycosis vary from 50% to 100% . Jimenez‐Garcin et al reported that 91.8% of patients treated with topical clotrimazole were cured after 2 weeks of continuous treatment, while 80% treated with topical tolnaftate were cured in the same perioid . Dundar and Lynen used single‐dose topical application of clotrimazole to treat otomycosis with 95% of patients cured .…”

Section: Discussionmentioning

confidence: 99%

“…Otomycosis is very common in southern China, but its symptoms are diversified. Although there are many treatment methods reported in the domestic and foreign literature, few of these methods have been effective clinically to control repeated attacks . Early detection and standardised treatment are the keys for obtaining a higher cure rate of otomycosis …”

Section: Introductionmentioning

confidence: 99%

“…Extensive clinical application of otoendoscopy enables more patients with otomycosis to be diagnosed at an early stage. Local cleaning and continuous lavage of antifungal drugs are important measures to control symptoms quickly and inhibit fungal recurrence for a long time …”

Section: Introductionmentioning

confidence: 99%

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Diagnosis and treatment of otomycosis in southern China

2019

Mycoses

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Summary To analyse and discuss the clinical features and pathogenic characteristics, diagnosis and treatment of patients with otomycosis in southern China. Two hundred fifty‐six patients from southern China diagnosed with otomycosis were randomly separated into two groups: the drug filling group and drug smearing group. Patients in the drug filling group were first examined and then had the pathogenic secretions in their external auditory canals cleared by otoendoscopy. Then, the local antifungal cream triamcinolone acetonide clotrimazole was injected into the external auditory canal. The same treatment was undertaken 1 week later and repeated once or twice more. Patients in the drug smearing group were also treated by otoendoscopy. Then, they were told to smear their external auditory canals once per day with the antifungal cream. All cases were followed for more than 6 months after the 3‐ to 4‐week treatment. The main symptoms and otoendoscopic examination were used to evaluate the prognosis. Aspergillus was the commonest fungus. The cure rate was 93% in the drug filling group and 81% in the drug smearing group. Otomycosis is very common in southern China, but it lacks characteristic features in its early stages. Once diagnosed, the local lesions in the external auditory canal should be cleared thoroughly using otoendoscopy, and then, the local antifungal cream is injected into external auditory canal. The cure rate can be significantly improved with the foregoing treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnosis and treatment of otomycosis in southern China

2019

Mycoses

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Topical azole treatments for otomycosis

Lee

Tysome

Saeed

2021

Cochrane Database of Systematic Reviews

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A Comparison of Triamcinolone Acetonide Econazole Cream and Nystatin Suspension in Treatment of Otomycosis

et al. 2020

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Objectives/Hypothesis To compare the efficacy and adverse effects of triamcinolone acetonide econazole cream and nystatin suspension in the treatment of otomycosis, and to determine the clinical features, predisposing factors, and etiology of otomycosis. Study Design A prospective study. Methods A prospective clinical trial was conducted on 786 patients diagnosed with otomycosis. The study population was randomly divided into two treatment groups of triamcinolone acetonide econazole cream (TAEC) and nystatin suspension in a 1:1 ratio. After clearing all fungal deposits in the external auditory canal, the antimycotic drugs were locally applied for at least 2 weeks. The efficacy and adverse effects were compared between the two antifungal reagents by statistical analysis. Meanwhile, patient clinical data were collected to find out the clinical features, predisposing factors, and etiology. Results Pruritis was the most common symptom and Aspergillus niger was the leading fungal pathogen. There was high association (44.5%) of otomycosis with a history of unclean ear picking. The cure rate was 97.6% in the TAEC group and 73.5% in the nystatin group (P < .01). Treatment with TAEC resulted in 2.4% of patients complaining of discomforts (irritant dermatitis, otalgia, or headache) versus 59.8% of patients complaining discomforts treated with nystatin (P < .01). The residue rate of antifungals was 1.9% in the TAEC group and 89.9% in the nystatin group (P < .01) at the end of treatment. Conclusions Thoroughly cleaning of the external auditory canal followed by local use of TAEC under endotoscope is an effective, convenient, and well‐tolerated treatment for otomycosis. Level of Evidence 1 Laryngoscope, 131:E1640–E1646, 2021

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Efficacy of topical clotrimazole vs. topical tolnaftate in the treatment of otomycosis. A randomized controlled clinical trial

Cited by 25 publications

References 19 publications

Diagnosis and treatment of otomycosis in southern China

Diagnosis and treatment of otomycosis in southern China

Topical azole treatments for otomycosis

A Comparison of Triamcinolone Acetonide Econazole Cream and Nystatin Suspension in Treatment of Otomycosis

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