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抗真菌药物类型:它对耳霉菌病的经验性治疗有影响吗?

Type of Antifungals: Does it Matter in Empirical Treatment of Otomycosis?

作者信息

Navaneethan Nagendran, YaadhavaKrishnan Raj Prakash Dharmapuri

机构信息

Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, Tamil Nadu India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2015 Mar;67(1):64-7. doi: 10.1007/s12070-014-0780-9. Epub 2014 Oct 4.

Abstract

To evaluate the efficacy of clotrimazole, miconazole and fluconazole in empirical treatment of otomycosis in our tertiary care hospital and to appraise possible better outcome in otomycosis. Two hundred and ninety five patients who presented with clinical otomycosis at our Melmaruvathur Adiparasakthi Institute of medical sciences were incorporated in this study. Two hundred and fourteen patients who satisfied our criteria were recognized and they were randomly alienated into three groups A, B, C. Group A patients were advised to instill clotrimazole ear drops by themselves. Miconazole cream instillation were done by our trained personal in group B patients. Group C patients were advised to use fluconazole ear drops. Patients were educated to keep ear dry and instructed to come for evaluation in first and second week after initial visit. A randomized double blinded prospective study. In the first week, clotrimazole had a good response than miconazole and fluconazole in our patients and in the second week, our patients showed a drastic response in patients instilling flucanozole ear drops compared to those using micanozole and clotrimazole. This better outcome doesn't show statistical significance since p value is 0.882. Clotrimazole drops, miconazole cream and Fluconazole drops showed almost same therapeutic efficacy in Otomycosis.

摘要

评估克霉唑、咪康唑和氟康唑在我们三级护理医院经验性治疗耳真菌病中的疗效,并评估耳真菌病可能取得的更好治疗效果。纳入本研究的是在我们梅尔马鲁瓦图尔阿迪帕拉萨基医学科学研究所出现临床耳真菌病的295名患者。确认了214名符合我们标准的患者,并将他们随机分为A、B、C三组。建议A组患者自行滴注克霉唑耳滴剂。由我们训练有素的人员对B组患者进行咪康唑乳膏滴注。建议C组患者使用氟康唑耳滴剂。告知患者保持耳部干燥,并指示他们在初次就诊后的第一周和第二周前来进行评估。一项随机双盲前瞻性研究。在第一周,在我们的患者中,克霉唑的反应比咪康唑和氟康唑好;在第二周,与使用咪康唑和克霉唑的患者相比,滴注氟康唑耳滴剂的患者有明显反应。由于p值为0.882,这种更好的治疗效果没有统计学意义。克霉唑滴剂、咪康唑乳膏和氟康唑滴剂在耳真菌病中显示出几乎相同的治疗效果。

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