Comparison of effectiveness of 7.5% Povidone-iodine with 1% Clotrimazole ear drops and lignocaine in Otomycosis
Objectives: Our study is comparing the effectiveness of 7.5% Povidone-iodine with 1% Clotrimazole ear drops and lignocaine in the management of Otomycosis to highlight the importance of replacing conventional antifungals in routine practice.
Setting: Department of ENT and Head and Neck Surgery, Holy Family Hospital, Rawalpindi, Pakistan.
Study design: A prospective randomized control trial
Methodology: This study was conducted for 12 months in our institute from July 2014 to June 2015. A total number of 148 patients with clinically diagnosed Otomycosis between the age group 15 to 55 years were studied. All patients with a clinical diagnosis of Otomycosis presenting with all four features of earache, itching, ear-blockage, and ear discharge in ENT OPD were included. Ear swabs were taken and sent for fungal culture. Patients were divided into A and B groups each comprising of 74 patients. Group A received 1% Clotrimazole ear drops and lignocaine and group B received 7.5% Povidone-iodine for 14 days after the results of cultures were received. At the end of 14 days, patients of both groups were compared based on the resolution of symptoms and signs.
Results: At the end of 14 days, 32 out of 74 patients (43%) in group A receiving 1% Clotrimazole ear drops and lignocaine reported resolution of all symptoms, and 52 out of 74 patients(70%) showed complete resolution of all signs, while in group B,68 out of 74 patients(91%) showed complete resolution of symptoms and 69 out of 74 patients (93%) showed complete resolution of signs. Our study showed significant improvement in signs and symptoms of Otomycosis achieved by treatment with 7.5% Povidone-iodine compared to that achieved by 1% Clotrimazole ear drops and lignocaine.
Conclusion: 7.5% Povidone-iodine is a more effective antifungal agent in the treatment of Otomycosis as compared to 1% Clotrimazole ear drops and lignocaine.
2. Ozcan KM, Ozcan M, Karaarslan A, Karaarslan F. Otomycosis in Turkey: predisposing factors, aetiology and therapy. The Journal of Laryngology & Otology. 2003 Jan; 117(1):39-42.
3. Pradhan B, Tuladhar NR, Amatya RM. Prevalence of Otomycosis in Outpatient Department of Otolaryngology in Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Annals of Otology, Rhinology & Laryngology. 2003; 112(4):384-7.
4. Ozcan M, Ozcan MK, Karaarslan A, Karaarslan F. Concomitant Otomycosis and Dermatomycoses: A Clinical and Microbiological Study. European archives of Oto-Rhino-Laryngology. 2003; 260(1):24-7.
5. Kumar A. Fungal spectrum in otomycosis patients. 2005.
6. Ho T, Vrabec JT, Yoo D, Coker NJ. Otomycosis: Clinical Features and Treatment Implications. Otolaryngology--Head and Neck Surgery. 2006;135(5):787-91.
7. Martín A, Canut A, Muñoz S, Pescador C, Gómez J. Otomycosis: Presentation of 15 cases. EnfermedadesInfecciosas y microbiologiaclinica. 1989;7(5):248-51.
8. Philip A, Thomas R, Job A, Sundaresan VR, Anandan S, Albert RR. Effectiveness of 7.5 percent Povidone Iodine in Comparison to 1 percent Clotrimazole with Lignocaine in the treatment of Otomycosis. ISRN otolaryngology. 2013.
9. Vennewald I, Klemm E. Otomycosis: diagnosis and treatment. Clinics in Dermatology. 2010;28(2):202-11.
10. Jia X, Liang Q, Chi F, Cao W. Otomycosis in Shanghai: Aetiology, Clinical Features and Therapy. Mycoses. 2012;55(5):404-9.
11. Mgbor N, Gugnani H. Otomycosis in Nigeria: Treatment with Mercurochrome. Mycoses. 2001;44(9‐10):395-7.
12. Munguia R, Daniel SJ. Ototopical antifungals and otomycosis: A Review. International journal of Pediatric Otorhinolaryngology. 2008;72(4):453-9.
13. Van der Linden JW, Snelders E, Kampinga GA, Rijnders B, Mattsson E, Debets-Ossenkopp YJ, et al. Clinical Implications of azole resistance in Aspergillusfumigatus, The Netherlands, 2007-2009. 2011.
14. Van der Linden J, Arendrup M, Warris A, Lagrou K, Pelloux H, Hauser P, et al. Prospective multicenter international surveillance of azole resistance in Aspergillusfumigatus. Emerging infectious diseases. 2015; 21(6):1041.
15. Gonçalves SS, Souza ACR, Chowdhary A, Meis JF, Colombo AL. Epidemiology and Molecular Mechanisms of antifungal resistance in Candida and Aspergillus. Mycoses. 2016.
16. Gharaghani M, Seifi Z, Mahmoudabadi AZ. Otomycosis in Iran: a review. Mycopathologia. 2015 Jun 1; 179(5-6):415-24.
17. Dai Y, She W, Zhu W, Zhang Q, Chen F, Yu C, Wang J, Gao X. Diagnosis and treatment of mycotic otitis media. Lin Chuang er bi yanhoutou Jing waikezazhi= Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery. 2009 Jan 1; 23(1):11-3.
18. Viswanatha B, Naseeruddin K. Fungal infections of the ear in immunocompromised host: a review. Mediterranean Journal of Hematology and Infectious Diseases. 2011; 3(1).
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