Research ID | Class of drugs used (Topical unless specified) | Treatment (Detailed) | Duration of treatment | Ear toileting |
Cimolai N, 2020 |
Hydroxyquinoline
|
1% - 3% Clioquinol
|
Unspecified
|
Unspecified
|
Jimenez-Garcia L et al, 2020 |
Azole versus thiocarbamate
|
Group 1 - Clotrimazole cream was applied to ears and left for 7 days Group 2 - Patients were instructed to apply Tolnaftate solution 2 drops every 12 h for 7 days |
1 week
|
Group 1 - Cream residue removed from EAC after 7 days Group 2 - EAC cleaned and dried after 7 days |
Mohammed W et al, 2020 |
Azoles (topical & oral) and polyene
|
Clotrimazole, fluconazole, nystatin or miconazole. If no response,
patient treated with systemic antifungal (fluconazole and
voriconazole)
|
Unspecified
|
Clearance of fungal mass
|
Moslem M & Mahmoudabadi AZ, 2020 |
Azoles versus echinocandin versus polyene
|
Luliconazole, voriconazole, caspofungin and amphotericin B
|
Not applicable
|
Not applicable
|
Abastabar M, 2019 |
Cephalosporin (oral), aminoglycosides, polyene and allylamine
|
Oral Cefixime 400 mg/d and topical gentamicin Topical nystatin 100 000 U/g TDS and terbinafine 250 mg TDS |
Unspecified
|
Unspecified
|
Al-Hashimi et al, 2019 |
Azole versus thiocarbamate versus combination of azole and
steroids
|
1st group - Clotrimazole solution / clotrimazole cream 2nd group - Tolnaftate solution 3rd group for severe candida infection- Clotrimazole mixed with steroid for 2 days, then extraction of mass, then clotrimazole with steroid for a further 5 days, then steroid cessation and continuation of clotrimazole for 2 weeks For severe Aspergillus niger infection - Tolnaftate mixed with steroid for 2 days, then extraction of mass, then tolnaftate with steroid for a further 5 days, then steroid cessation and continuation of tolnaftate for 2 weeks |
2 weeks
|
Suction of ear canal and cleaning by dry method For severe infection, extraction of mass, after washing, complete cleaning and drying of ear |
Teharia RK & Narvey VP, 2019 |
Antiseptic versus azole
|
Group A - Betadine (povidone iodine 10%) 10 ml solution ear wash using syringes at each visit Group B - 4 drops of clotrimazole 1% QID |
20 days
|
Ear washing with 10% betadine 10 ml solution using syringes at each
visit
|
Sumbria D et al, 2019 |
Azole versus azole versus thiocarbamate versus combination of azole,
antibiotic and steroids
|
Group 1 - 1% Luliconazole lotion Group 2 - 2% Sertaconazole cream Group 3 - 1% Terbinafine hydrochloride cream Group 4 - 0.5% Fluconazole gel Group 5 - 1% Clotrimazole lotion Group 6 - Combination of 1% clotrimazole, chloramphenicol and beclomethasone eardrops |
4 weeks
|
Dry aural toileting with swab stick
|
Kiakojori K et al, 2019 |
Azole
|
Clotrimazole 2 drops 3 times per week
|
4 weeks
|
Cleaning and drying of ear canal
|
Dundar R & Iynen I, 2019 |
Azole
|
The ear canal was filled with 1% clotrimazole cream
|
7-15 days
|
Cleaning of ear canal by microsuction
|
Hivary S et al, 2019 |
Azoles versus polyene versus echinocandin
|
Luliconazole, amphotericin B, posaconazole and caspofungin
|
Not applicable
|
Not applicable
|
Kanade SM, 2018 |
Azole versus Azole
|
Group A - 1% Clotrimazole eardrops, 3-5 drops TDS instilled by the patient Group B - 0.3% Fluconazole eardrops, 3-5 drops TDS instilled by the patient For proper administration of eardrops, instructions were given by a trained nurse assistant |
3 weeks
|
Patients were advised to keep the ear dry
|
Ahmed MR et al, 2018 |
Azoles versus polyene macrolide antibiotic
|
Ketoconazole 2% cream, Miconazole 2% cream Nystatin 100 000 U/g cream was used for Candida spp. |
2 weeks
|
Removal ear canal debris
|
Kiakojori K et al, 2018 |
Azole
|
2% Miconazole ointment
|
Unspecified
|
Suction clearance and removal of colonies ± 2% oxygenated solution /
distilled water / normal saline followed by drying of the ear
|
Mofatteh MR et al, 2018 | Antiseptic alone versus azole, thiocarbamate & antiseptic | Group 1 - washed by physician using 10 ml betadine 10% with syringe Group 2 - 8 drops of clotrimazole 8 hourly For resistant cases, tolnaftate and Gentian Violet were used |
20 days
|
Ear washing with 10 ml betadine 10% with syringe
|
Mahdavi OS et al, 2018 |
Combination of cephalosporin and azole versus azole alone
|
1% Clotrimazole cream injected into ear canal under the microscope for both groups Intervention group received ceftizoxime 1 g powder sprayed in ear canal using insufflation |
Unspecified
|
Suction clearance
|
Ali K et al, 2018 |
Polyenes versus azoles versus allylamine
|
Amphotericin B 100 units and nystatin 100 units fluconazole 25 ug, ketoconazole 10 ug, clotrimazole 10 ug, voriconazole 1 ug and itraconazole 10 ug Terbinafine 25 ug |
Not applicable
|
Not applicable
|
Nagl M et al, 2018 |
Chloramine, steroids and azole
|
Cotton strip soaked with 1% N-chlorotaurine (NCT) plus 0.1% dexamethasone. The strip was changed daily 1% clotrimazole strip was used in case of relapse Treatment was changed again to 1% NCT plus 0.1% dexamethasone |
8 days
|
Unspecified
|
Chappe M et al, 2018 |
Polyene & azole
|
Nystatin (Auricularum®, Grimberg) BD for 1 month Econazole cream was started 7 months later due to relapse, but was difficult to apply. Finally, 1% voriconazole solution was used TDS / QID for 14 days |
14 days after relapse
|
Ear canal suction
|
Baumgardner DJ, 2017 |
Mixture of acidifying agent and alcohol or azole
|
2% acetic acid in propylene glycol or 1% clotrimazole solution
|
Unspecified
|
Unspecified
|
Agarwal P & Devi LS, 2017 |
Azole
|
Clotrimazole drops, 4-5 times daily
|
10-14 days
|
Thorough aural toilet
|
Mishra D et al, 2017 |
Azole versus azole
|
Group A - Patients were instructed to instil 1% clotrimazole 3 drops TDS Group B - 1% clotrimazole cream was squirted into 2 ml syringe and ear canal was filled with this cream under endoscopic guidance |
1 week
|
Unspecified
|
Arndal E et al, 2016 |
Azoles versus polyene versus steroids versus antiseptics versus
allylamine
|
Clotrimazole, miconazole Nystatin Hydrocortisone Methylrosanilin (Gentian Violet) Terbinafine |
Unspecified
|
Unspecified
|
Arifullah et al, 2016 |
Acidifying agent & azole
|
1% clotrimazole lotion or cream (impregnated gauze)
|
1-3 weeks
|
Local debridement, ear cleaning with dilute aluminium acetate solution
combined with acetic acid
|
Nandyal CB & Choudhari AS, 2015 |
Azole versus Azole
|
1% Clotrimazole eardrops TDS were used in 70 cases 1% miconazole eardrops TDS were used in 65 cases |
2 months
|
Cleaning of fungal mass and debris in infected ear canal either by dry
mopping (98%), microsuction (4.4%) or syringing (0.74%)
|
Vadisha SB et al, 2015 |
Azoles
|
Topical clotrimazole was widely used For patients who did not respond to clotrimazole, fluconazole was an alternative |
3 weeks
|
Suction clearance of fungal debris
|
Zarei Mahmoudabadi A et al, 2015 |
Azoles versus polyene versus allylamine
|
Clotrimazole 50 ug/disk Miconazole 10 ug/disk Nystatin 100 ug/disk 10% terbinafine (Lamisil) stock was prepared with dimethyl sulfoxide 12 ug/disk |
Not applicable
|
Not applicable
|
Abed AR & Hussein IM, 2015 |
H2O2 versus antiseptic versus acidifying agent
|
3% H2O2, 1% Iodine, 2% Acetic acid
|
Not applicable
|
Not applicable
|
Navaneethan N & YaadhavaKrishnan RP, 2015 |
Azole versus azole
|
Group A - 1% Clotrimazole eardrops, 3-5 drops TDS Group B - Two application of miconazole cream, once during initial visit and second application during first week review for persistent disease Group C - Fluconazole drops, 3-5 drops TDS |
2 weeks
|
Aural toileting
|
Naqi S et al, 2014 |
Azole
|
Clotrimazole lotion BD
|
2 weeks
|
Unspecified
|
Anwar K & Gohar MS, 2014 |
Azole / acidifying agents in alcohol / polyene (oral)
|
Clotrimazole 1% lotion or cream / 2% salicylic acid in alcohol /
ototopical drops with propylene glycol / antimicrobial / fluconazole /
nystatin (Nilstat)
|
1 week
|
Aural cleaning
|
Adoga AS & Iduh AA, 2014 |
Combination of azole, antibiotic, local anaesthetics, steroid, alcohol,
hydroxyquinoline / steroid
|
Discontinuation of antibiotics Combination of clotrimazole, Chloramphenicol, lignocaine hydrochloride, Beclomethasone, glycerine (Candibiotic®) in 98.0%, Clioquinol / Flumethasone (Locacorten Vioform®) in 2.0% |
2 weeks
|
Aural toileting
|
Nemati S et al, 2014 |
Azoles & polyene
|
Clotrimazole, fluconazole, ketoconazole and nystatin
|
Not applicable
|
Not applicable
|
Prasad SC et al, 2014 |
Azole
|
Clotrimazole 4-5 drops TDS
|
7-14 days
|
Aural toilet by suctioning and removal of fungal debris
|
Philip A et al, 2013 |
Antiseptic versus combination of azole with local anaesthetic
|
Group 1 - 3 drops of 1% clotrimazole & 2% lignocaine in propyl glycerol were instilled in the affected ear OD Group 2 - 3 drops of 7.5% povidone-iodine were instilled in the affected ear OD |
2 weeks
|
Thorough toileting of the ear canal
|
Khan F et al, 2013 |
Azole
|
Clotrimazole lotion 5 drops TDS
|
2 weeks
|
Unspecified
|
Neji S et al, 2013 |
Azole
|
Ecorex ® (econazole nitrate) 5 drops BD
|
10 weeks
|
Intense cleaning
|
Dorasala SP & Dorasala S, 2013 |
Antifungal & antibiotic
|
Pressed and cut medicated Gelfoam pieces soaked in topical antifungal and antibiotic ear drops Patients advised to instil eardrops over Gelfoam for 3 days |
3 days
|
Cleaning of all fungal debris
|
Shraga S et al, 2013 |
Antifungal
|
Shraga Cream: 0.1% Betamethasone, 10% Griseofulvin, 35% Lanolin, 20% Petroleum jelly (Vaseline®) , 15% Tea tree oil and 20% Distilled water Shraga Ear drops: 0.1% Betamethasone, 10% Griseofulvin, 15% Tea Tree oil, 25% Petroleum jelly (Vaseline®) and 50% Distilled water OD |
1 week
|
Unspecified
|
Kolling WM et al, 2013 |
Combination of azole and anaesthetic vs azole alone vs analgesic
(oral)
|
1% clotrimazole 4 drops TDS Oral ibuprofen 2 drops of 1% topical tetracaine in propylene glycol 5 minutes followed by 4 drops of 1% clotrimazole |
2 weeks
|
Cleaning of ear canal
|
Block TK & Munson E, 2012 |
Azole
|
1% Clotrimazole eardrops
|
Improvement noted following 2 days of therapy
|
Unspecified
|
Schaefer P & Baugh RF, 2012 |
Acidifying agent, half acidifying agent/ half alcohol or
antifungals
|
Acetic acid 2% (Vosol) otic solution 2 drops BD
|
7 to 10 days
|
Meticulous cleaning of ear canal
|
Viswanatha B et al, 2012
|
Azole versus Azole
|
Discontinuation of topical antibiotics Initial treatment regimen - clotrimazole eardrops. Patients who did not respond to clotrimazole were switched to fluconazole eardrops. |
3 weeks
|
Microscopic suction clearance of fungal mass
|
Edward et al, 2012 |
Antiseptics, polyene, azoles
|
Boric acid, Gentian Violet 1%, Castellani’s paint, Cresylate Otic drops, Mercurochrome, Nystatin cream / ointment / powder, Clotrimazole, ketoconazole, fluconazole, miconazole cream 2%, Bifonazole 1% solution, Itraconazole Case report - Gentian Violet |
5 days
|
Mechanical debridement
|
Vyas DH & Shah PD, 2011 |
Polyene (IV)
|
IV Amphotericin B
|
Unspecified
|
Suction clearance & debridement
|
Viswanatha B & Nasseruddin K, 2011 |
Azoles
|
Clotrimazole eardrops / fluconazole eardrops
|
3-4 weeks
|
Microscopic suction clearance of fungal mass
|
Hsu CL et al, 2011 |
Azoles (oral & IV), aminoglycoside (oral), polyene (oral), beta-lactams
(oral)
|
Initially, oral ketoconazole 400 mg QID for 2 weeks IV fluconazole 200 mg QID, gentamicin 160 mg QID, gentamicin replaced after 3 days by amphotericin B 30 mg QID and piperacillin and tazobactam 2.25 g 8 hourly for 4 days After obtaining culture result, IV voriconazole (loading dose 300 mg every 12 h for 1 day; maintenance dose 200 mg every 12 h for 5 days) Oral voriconazole 200 mg BD was administered for 5 further days |
4 weeks
|
Daily clearing of ear discharge
|
Lee A et al, 2011 |
Azole
|
1% clotrimazole
|
14 days
|
Suction clearance and dry mopping of debris
|
Yaganeh Moghadam A et al, 2010 |
Mixture of alcohol & acidifying agent
|
Mixture of 90 ml of 70% isopropyl alcohol + 10 ml of 2% acetic acid
every 8 h
|
3 weeks
|
Unspecified
|
Mgbe R et al, 2010 |
Hydroxyquinoline / steroids / azole / local anaesthetics /
antiseptic
|
Ears packed with wick impregnated with either clioquinone / flumethasone
(Locacorten Vioform eardrops/cream) or beclomethasone dipropionate /
clotrimazole / lidocaine hydrochloride (Candibiotic ear drops) or
Gentian Violet changed thrice daily
|
2 weeks
|
Aural syringing
|
Chalabi EY & Ahmed TS, 2010 |
Azole drops
|
1% clotrimazole 2 drops BD
|
3 weeks
|
Group A - Suction cleaning (dry ear cleaning) Group B - Gentle (wet ear cleaning) syringing by using clean water at body temperature or normal saline |
Parize P et al, 2009 |
Azoles (oral), polyene (oral), echinocandin (oral)
|
1st case: Oral voriconazole 200 mg BD 2nd case: Oral voriconazole first at 200 mg BD, then at 300 mg BD to obtain a trough concentration of more than 1 mg/L Review: 17 patients received 2 g amphotericin B, 9 of the 17 patients received amphotericin B and itraconazole. 1 patient first received itraconazole and was switched to amphotericin B because of a relapse In 3 cases, itraconazole was used as the only antifungal 1 patient received both voriconazole and caspofungin | 3 months for the 1st case 12 months for the 2nd case |
Unspecified
|
Malik MF et al, 2009 |
Antiseptic versus azoles
|
Tincture Merthiolate or clotrimazole or miconazole 4 drops BD
|
14 days
|
Cleaning by dry mopping
|
Ibiam FA, 2009 |
Hydroxyquinoline
|
Locorten-Vioform® 2-3 drops QID
|
3 weeks
|
Aural dry mopping
|
Kiakojori K et al, 2007 |
Azole versus combination of azole and acidifying agent
|
First step - 2% miconazole Second step - Combination of 2% miconazole and acidic acid drops (acetic acid 3% in ethanol 97%) |
21 days
|
Suction clearance
|
Ong YK & Chee G, 2005 |
Acidifying / drying agent and azole
|
Acetic acid 2% and topical clotrimazole eardrops
|
Unspecified
|
Aural toilet
|
Özcan KM et al, 2005 |
Antiseptic in distilled water versus antiseptic in alcohol
|
Boric acid solution in 70% distilled water, boric acid solution in 70%
ethanol
|
Not applicable
|
Not applicable
|
Panizza BJ, 2002 |
Combination of antibiotic, corticosteroids and antifungal
|
Combination of ciprofloxacin, hydrocortisone and antifungal ear
drops
|
1 week
|
Suction clearance, dry mopping of canal with probe
|
Sander R, 2001 |
Acidifying drops / azoles (topical / oral)
|
2% acetic acid TDS / QID If symptoms persist, 1% clotrimazole (Lotrimin) Aspergillus infection resistant to clotrimazole required oral itraconazole (Sporanox) |
1 week
|
Cleansing of ear canal by suctioning
|
BD - Twice daily OD - Once daily QID - Four times a day TDS - Three times daily NCT - N-Chlorotaurine EAC - External auditory canal | BD - Twice daily OD - Once daily QID - Four times a day TDS - Three times daily NCT - N-Chlorotaurine EAC - External auditory canal | BD - Twice daily OD - Once daily QID - Four times a day TDS - Three times daily NCT - N-Chlorotaurine EAC - External auditory canal | BD - Twice daily OD - Once daily QID - Four times a day TDS - Three times daily NCT - N-Chlorotaurine EAC - External auditory canal | BD - Twice daily OD - Once daily QID - Four times a day TDS - Three times daily NCT - N-Chlorotaurine EAC - External auditory canal |