Topical
The topical formulations included drops, creams, ointments, powders, solutions, lotions and sprays which were given alone or in combination. Eardrops were prescribed in 38% of studies, solutions in 18%, creams in 15%, ointments in 2% and powders in 2%. Among eardrops, clotrimazole-containing drops were used most frequently (33%). Among topical solutions, antiseptic-containing ones were the most popular (45%). 1% clotrimazole cream was preferred over 1% clotrimazole drops in one study as it required a single application. The use of impregnated strips, wicks and gauze was mentioned in a few studies. Nagl M et al (14) used a cotton strip soaked in N-Chlorotaurine and dexamethasone which was changed daily for 8 days in a recalcitrant case. Arifullah et al (15) impregnated gauze with 1% clotrimazole lotion or cream. Dorasala SP & Dorasala S (1) introduced medicated absorbable gelatin sponge pieces (Gelfoam) in layers under the microscope and advised patients to instil a combination of antifungal and antibiotic ear drops for 3 days.