Objective: To compare the efficacy and local adverse effects of Isoconazole Nitrate versus Nystatin for the treatment of patients having Otomycosis
Sudy Design: Group experimental study.
Study Setting & Duration: Department of Otolaryngology, Head & Neck Surgery at Rawalpindi Teaching Hospital, Rawalpindi. Duration of study was 6 months after approval by Ethical Committee from Feb 2023 to july 2023
Materials and Methods: Total of 64 patients were selected. The study participants were individuals who, according to operational definitions had Otomycosis and who had presented for evaluation at the Department of Otolaryngology Rawalpindi teaching Hospital, Rawalpindi. They also met all inclusion and exclusion criteria requirements and these requirements were strictly adhered to in order to control confounders and bias. Isoconazole nitrate ointment was used to treat patients in Group A and Nystatin ointment was used to treat instances in Group B. Patients were chosen by randomization using lottery method. SPSS 28 was used to determine the frequencies in the data.
Results: 64 individuals (32 cases in each group) were chosen for the study by the ENT outpatient clinic. Out of which 33 (51.6%) being female and 31 (48.1) being male. The age ranged from 12 to 80 years, with a mean age of 44.29 ±19.13. After two weeks, there was a substantial improvement in 25 (39.06%) of the group A patients (p=0.08), a moderate improvement in 7 (10.9%), and a minor improvement in 5 (7.81%) patients (p=0.37) while in group B exhibited a substantial improvement in just 19 (10.9%) (p=0.08), a moderate improvement in 9 (39.0%) (p=0.38), and a small improvement in 7 (42.19%) (p=0.37). After four weeks 21 (32.81%) in Group B showed insignificant improvement, while 26 (40.63%) in Group A exhibited better improvement than Group B. The treatment for group A, which included isoconazole nitrate, was substantially more successful than the Nystatin treatment for group B. Isoconazole was found insignificantly more effective than (p=0.08). The majority of patients in both groups didn't notice any adverse .
Conclusion: Nystatin was shown to be significantly less efficacious than isoconazole nitrate ointment in treating otomycosis.
Lotfali E , Ghasemi R, Masoumi N, Molavizadeh D, Sadeghi S, et al. Isolation, Characterization, and Antifungal Sensitivity Pattern of Fungal Species with Potential Resistance to Antifungal Drugs in Patients with Otomycosis. Arch Clin Infect Dis. 2022;17(4):e129169. https://doi.org/10.5812/archcid-129169.
Xu S, Li J, Ding L, Gao K, Xie F, Han J, Zhou X. Efficacy and safety of terbinafine hydrochloride spray and 3% boric acid alcohol ear drops in otomycosis. Acta Otolaryngol. 2020 Apr;140(4):302-306. Doi: 10.1080/00016489.2020.1712474
Haq M, Deshmukh P. Review of Recurrent Otomycosis and Clotrimazole in Its Treatment. Cureus. 2022 Oct 9;14(10):e30098. Doi: 10.7759/cureus.30098.
Kiakojuri K, Rajabnia R, Mahdavi Omran S, Pournajaf A, Karami M, Taghizadeh Armaki M. Role of Clotrimazole in Prevention of Recurrent Otomycosis. Biomed Res Int. 2019 Dec 26;2019:5269535. doi: 10.1155/2019/5269535
Dundar R, İynen İ. Single Dose Topical Application of Clotrimazole for the Treatment of Otomycosis: Is This Enough? J Audiol Otol. 2019 Jan;23(1):15-19. doi: 10.7874/jao.2018.00276.
Lee A, Tysome JR, Saeed SR. Topical azole treatments for otomycosis. Cochrane Database Syst Rev. 2021 May 25;5(5):CD009289. doi: 10.1002/14651858.CD009289
Khan MA, Akram S, Anwar K, Ahmad A, Khan M, Hakim A. Prevalence, clinical profile and seasonal variation of otomycosis in Pakistan. International Journal of Pathology. 2020 Oct 5:26-30.
Hossain CM, Ryan LK, Gera M, Choudhuri S, Lyle N, Ali KA, et al. Antifungals and Drug Resistance. Encyclopedia [Internet] 2022;2(4):1722–37. Available from: http://dx.doi.org/10.3390/encyclopedia2040118
Ghannoum MA, Rice LB. Antifungal agents: mode of action, mechanisms of resistance, and correlation of these mechanisms with bacterial resistance. Clin Microbiol Rev. 1999 Oct;12(4):501-17. doi: 10.1128/CMR.12.4.501.
Gülüstan F, Abakay MA, Demir E. Efficacy of topical isoconazole nitrate in the treatment of otomycosis. Am J Otolaryngol. 2021 Jul-Aug;42(4):102961. doi: 10.1016/j.amjoto.2021.102961
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) 2023 Amna Kausar, Sadia Chaudhry, Nighat Qammar, Ansa Umara Akram, Ashar Alamgir, Wajid Hussain