Which medications in the drug class Antifungals, Other are used in the treatment of Otitis Externa?

Updated: Mar 09, 2020
  • Author: Ariel A Waitzman, MD, FRCSC; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
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Antifungals, Other

A small but significant percentage of OE cases are due to Aspergillus species or other yeasts and fungi (otomycosis). Some cases of fungal OE can be treated with acidifying drops; topical antifungal agents are used to treat otomycosis refractory to these drops. The mechanism of action of topical antifungal agents usually involves inhibition of the pathways (eg, enzymes, substrates, and transport) necessary for sterol/cell membrane synthesis or those involved in altering the permeability of the fungal cell membrane (eg, polyenes).

Clotrimazole 1% otic solution (Lotrimin AF)

Otic clotrimazole solution is a compounded medication. Clotrimazole is a broad-spectrum antifungal agent that inhibits yeast growth by altering cell membrane permeability, causing the death of fungal cells.

Nystatin powder (Nystop, Nyamic, Pedi-Dri)

Nystatin is a fungicidal and fungistatic antimicrobial obtained from Streptomyces noursei; it is effective against various yeasts and yeastlike fungi. It changes the permeability of the fungal cell membrane after binding to cell membrane sterols, causing the cellular contents to leak. Treatment should continue until 48 hours after the disappearance of symptoms. Topical application of nystatin reduces fungal growth.

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