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Related Experiment Videos

Ototoxicity of antimycotics.

R R Marsh1, L W Tom

  • 1Department of Otolaryngology and Human Communication, Children's Hospital of Philadelphia, PA 19104.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|February 1, 1989
PubMed
Summary

Antimycotic medications applied to damaged eardrums may harm hearing. Acetic acid and propylene glycol preparations showed ototoxicity in guinea pigs, unlike tolnaftate and clotrimazole.

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Area of Science:

  • Ototoxicology
  • Pharmacology
  • Otolaryngology

Background:

  • Otomycoses (fungal ear infections) and tympanic membrane perforations are common clinical conditions.
  • Antimycotic medications are used to treat fungal ear infections.
  • Potential for ototoxicity exists if medication enters the middle ear through a perforated tympanic membrane.

Purpose of the Study:

  • To evaluate the acute ototoxic potential of commonly used antimycotic preparations.
  • To determine if specific ingredients in antimycotic solutions contribute to ototoxicity.

Main Methods:

  • Five different antimycotic preparations were administered to guinea pigs.
  • Brainstem auditory evoked response (BAER) thresholds were measured to assess hearing function.
  • The study focused on the acute effects of the preparations on cochlear function.

Main Results:

  • Preparations containing acetic acid or propylene glycol significantly elevated BAER thresholds, indicating ototoxicity.
  • Antimycotic solutions of tolnaftate or clotrimazole in polyethylene glycol 400 caused minimal to no hearing impairment.
  • The vehicle (solvent) of the antimycotic preparation appears to influence its ototoxic potential.

Conclusions:

  • Certain antimycotic preparations, particularly those with acetic acid or propylene glycol, possess acute ototoxic potential.
  • Clinicians should exercise caution when prescribing topical antimycotics for fungal ear infections with tympanic membrane defects.
  • Further research into safer formulations of topical antifungals for otologic use is warranted.

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