Role of Clotrimazole in Prevention of Recurrent Otomycosis

Abstract

Otomycosis is one of the relatively common diseases in the world which is caused by different fungi especially saprophytes. Concerning the relapse of this disease in a number of individuals, the present study was performed to evaluate the inhibitory effect of clotrimazole drop in the relapse of otomycosis. Clinical samples were taken by an ENT specialist from patients suspicious of having otomycosis. A part of these samples were stained, and others were cultured. The diagnosis of otomycosis was made on the basis of the recognizable and characteristic appearance of fungal hyphae or mycelium and fruiting bodies and/or conidiophores under microscopic examination. Patients with suspected otomycosis are not at risk of recurrence after treatment with clotrimazole drops. Out of the 161 individuals in whom definite diagnosis of otomycosis was made, the most affected individuals were, in the age range of 40–49 years, women, urban citizens, and housewives. Pruritus and diminished hearing were the main complaints of the patients. Aspergillus niger and A. flavus as well as Candida albicans were the main causes of the disease. The relapse of disease was observed in only five patients (3.1%), where A. niger was the main fungus. Most relapses were observed in women and in those with diminished hearing, manipulating the ears, ulcers in the canal, and tympanum. Our results suggested that usage of clotrimazole can be effective in reducing the relapse of otomycosis, and concerning the high cost of treating otomycosis while the low cost of using clotrimazole, usage of this drop is recommended to reduce the relapse of otomycosis.

A Comparison of Antifungal Drugs and Traditional Antiseptic Medication for Otomycosis Treatment: A Systematic Review and Meta-Analysis

“…Antifungal drugs are generally cream preparations that partially cover the lesions, which are prone to recurrence. Non-antifungal drugs, by comparison, are generally liquid and penetrate deep into the external auditory canal, which not only reduces local inflammation and exudation but also completely covers the lesion ( 20 ). Second, antifungal drugs contain relatively tiny amounts of hormones, alleviating local inflammation and halting the proliferation of fungi more quickly than non-antifungal drugs.…”

Review of Recurrent Otomycosis and Clotrimazole in Its Treatment

“…Major relapse cases were seen in patients with irritated or ulcerated tympanum and canal. Clotrimazole drop may be used to stop the relapse of otomycosis in persons who have this condition, particularly those with ear and tympanic abnormalities [1].…”

“…One of the more widespread infections in the world is otomycosis, a disease that affects the external auditory canal (EAC). It primarily affects people who live in hot, dusty, and humid tropical and subtropical regions [1,2]. The occurrence of fungal infection is not only affected by geographical distribution, but also varies with distance and time [3].…”

“…The infection is typically unilateral and is characterized by otalgia, scaling, loss of hearing, erythema and acute pruritis, affecting people of all age groups ranging from infants to adulthood (81 years) with the average age being 30-40 years. Males and females are equally affected and there is no significant difference in the occurrence of the infection in rural and urban areas [1]. Diagnosis of the infection is made by collecting samples of discharge from the affected ear, wax and scrapings of scales present in the canal and detecting various fungal details, namely mycelium, pseudo-mycelium and yeast in the various samples.…”

“…Clotrimazole has been found to be 83% effective according to a study [12]. Its usage has also been proven to reduce the recurrence of the disease and the low cost of the drug in the market in comparison to the high cost of treatment of the disease makes it a suitable drug for the treatment of otomycosis and for the prevention of relapse of the disease [1].…”