Comparing the Therapeutic Effect of Clotrimazole and Tolnaftate in Treating the Variety of Fungal Species Producing Otomycosis in two Educational Hospital, Isfahan, Iran

Document Type : Original Article (s)

Authors

1 Professor, Department of Otolaringology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Otolaringology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

4 Associate Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Otomycosis is the superficial mycotic infection of the external ear canal which occurs as acute, subacute and chronic infection. It is the cause of 6.5% to 12.5% of external otitis. More than 62 species and 28 genera of fungi have been identified in patients with otomycosis among which the most common organisms are Aspergillus Niger and Candida Albicans. Recommended topical medications include steroids, anti-septic, acidic solutions, antifungal, and drying agents. The commonly recommended antifungal drugs are clotrimazole, amphotericin B, otosporin, and tolnaftate. This study aimed to identify two genera of fungus, and compare the efficacy of the treatment of clotrimazole and tolnaftate and the recurrence rate after the treatment.Methods: This was a clinical trial study conducted on 54 patients diagnosed with otomycosis (based on culture and smear with identification of the fungus genus and species). We compared the effect of clotrimazole and tolnaftate on the treatment and its recurrence on different types of fungus.Findings: After finishing the treatment course, 22 patients were improved in clotrimazole (81.5%); however, in the tolnaftate group, there were 21 improved patients (77.8%). Besides, Chi-square test showed no significant difference between the two groups (P = 0.99). Furthermore, out of 43 patients who have improved after the treatment, recurrence was seen in 15 of them (34.9%). Disease recurrence cases in the group treated with clotrimazole and tolnaftate were 8 and 7 patients respectively (36.4% vs. 33.3%). Although, the frequency distribution of disease recurrence was lower in the tolnaftate group, according to chi-square test, there was no significant difference between the two groups (P = 0.99).Conclusion: According to the results of this study and its comparison with other studies, both clotrimazole and tolnaftate had an appropriate impact on treating fungal infections of the ear. Given the non-improvement and recurrence cases, we should attempt to detect other therapeutic methods of otomycosis, and currently aspects such as financial and economic issues should be taken into account in choosing to use either of the drugs.

Keywords

References

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Journal of Isfahan Medical School
Volume 29, Issue 164 - Serial Number 164
September and October 2012
Pages 2117-2126

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History

  • Receive Date: 20 August 2011
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

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