Treatment of otomycosis with clotrimazole: results accordingly with the fungus isolated

Acta Otolaryngol. 2022 Sep-Dec;142(9-12):664-667. doi: 10.1080/00016489.2022.2117845. Epub 2022 Sep 20.


Background: Otomycosis is usually caused by Candida spp or Aspergillus spp. While Candida is usually multissensitive to available antifungals, Aspergillus is not. Topical antifungals for otomycosis that are available in Portugal are scarce, and systemic treatments have too many interactions and contraindications.

Objectives: Determine otomycosis epidemiology, microbiology and treatment results.

Methods: Observational study that included patients followed in Professor Doutor Fernando Fonseca Hospital, between 2011 and 2020. Otomycosis diagnosis was obtained through ear drainage culture, and every case was treated with 1% clotrimazole ear drops plus ear cleaning once per week.

Results: Aspergillus was found in ear drainage culture in 43.9% of patients and Candida in the remaining. There was a significant statistical difference between patients with otomycosis caused by Aspergillus versus Candida in treatment duration from 25.0 days (16.5-43.0) versus 14.0 days (7.0-18.5) (p < .001), respectively.

Conclusions: Otomycosis was more frequently caused by Candida, and this type of otomycosis is treated faster with clotrimazole 10 mg/dL plus ear cleaning, when compared with otomycosis by Aspergillus.

Significance: If otomycosis causative agent is identified or suspected, a prediction of the time needed till the resolution of otomycosis can be made, when clotrimazole ear drops are used.

Keywords: Aspergillus; Candida; Clotrimazole; Otomycosis.

Publication types

  • Observational Study

MeSH terms

  • Antifungal Agents / pharmacology
  • Aspergillus / drug effects
  • Aspergillus / isolation & purification
  • Candida / drug effects
  • Candida / isolation & purification
  • Clotrimazole* / pharmacology
  • Humans
  • Otomycosis* / drug therapy
  • Otomycosis* / microbiology
  • Treatment Outcome


  • Antifungal Agents
  • Clotrimazole