Mofatteh Mohammad Reza, Naseripour Yazdi Zahra, Yousefi Masoud, Namaei Mohammad Hasan
Birjand University of Medical Science, School of Medicine, Department of Ears, Nose and Throat, Birjand, Iran.
Birjand University of Medical Sciences, School of Medicine, Birjand, Iran.
Braz J Otorhinolaryngol. 2018 Jul-Aug;84(4):404-409. doi: 10.1016/j.bjorl.2017.04.004. Epub 2017 May 6.
Otomycosis is a common diseases that can be associated with many complications including involvement of the inner ear and mortality in rare cases. Management of otomycosis can be challenging, and requires a close follow-up. Treatment options for otomycosis include local debridement, local and systemic antifungal agents and utilization of topical antiseptics.
This study was designed to compare the recovery rate of otomycosis using two therapeutic methods; topical betadine (Povidone-iodine) and clotrimazole.
In this single-blind clinical trial, 204 patients with otomycosis were selected using a non-probability convenient sampling method and were randomly assigned to two treatment groups of topical betadine and clotrimazole (102 patients in each group). Response to treatment was assessed at 4, 10 and 20 days after treatment. Data were analyzed using the independent t-test, Chi-Square and Fisher exact test in SPSS v.18 software, at a significance level of p<0.05.
The results showed that out of 204 patients with otomycosis, fungi type isolated included Aspergillus in 151 cases (74%), and Candida albicans in 53 patients (26%). On the fourth day after treatment, 13 patients (13.1%) in the group treated with betadine and 10 patients (9.8%) in the group treated with clotrimazole showed a good clinical response to treatment (p=0.75). A good response to treatment was reported for 44 (43.1%) and 47 patients (46.1%) on the tenth day after the treatment (p=0.85); and 70 (68.6%) and 68 patients (67.6%) on the twentieth day after treatment (p=0.46) in the groups treated with betadine and clotrimazole, respectively. The response to treatment was thus not significantly different in the two groups.
In the present study the efficacy of betadine and clotrimazole was the same for the treatment of otomycosis. The result of this study supports the use of betadine as an effective antifungal in otomycosis treatment, helping to avoid the emergence of resistant organisms.
耳霉菌病是一种常见疾病,可能伴有多种并发症,包括内耳受累,在罕见情况下可导致死亡。耳霉菌病的治疗具有挑战性,需要密切随访。耳霉菌病的治疗选择包括局部清创、局部和全身抗真菌药物以及使用局部防腐剂。
本研究旨在比较两种治疗方法(局部使用碘伏(聚维酮碘)和克霉唑)治疗耳霉菌病的治愈率。
在这项单盲临床试验中,采用非概率方便抽样法选取204例耳霉菌病患者,并随机分为局部使用碘伏组和克霉唑组两个治疗组(每组102例患者)。在治疗后第4、10和20天评估治疗反应。使用SPSS v.18软件中的独立t检验、卡方检验和Fisher精确检验对数据进行分析,显著性水平为p<0.05。
结果显示,在204例耳霉菌病患者中,分离出的真菌类型包括151例(74%)曲霉菌和53例(26%)白色念珠菌。治疗后第4天,使用碘伏治疗组的13例患者(13.1%)和使用克霉唑治疗组的10例患者(9.8%)对治疗表现出良好的临床反应(p=0.75)。治疗后第10天,使用碘伏治疗组的44例患者(43.1%)和使用克霉唑治疗组的47例患者(46.1%)报告对治疗反应良好(p=0.85);治疗后第20天,使用碘伏治疗组的70例患者(68.6%)和使用克霉唑治疗组的68例患者(67.6%)报告对治疗反应良好(p=0.46)。因此,两组的治疗反应无显著差异。
在本研究中,碘伏和克霉唑治疗耳霉菌病的疗效相同。本研究结果支持使用碘伏作为治疗耳霉菌病的有效抗真菌药物,有助于避免耐药菌的出现。