Management of Otomycosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Area of Science:

• Otolaryngology
• Mycology
• Infectious Diseases

Background:

• Otomycosis, a fungal ear infection, lacks a universally agreed-upon most effective treatment.
• Determining the efficacy and safety of common otomycosis treatments is crucial for clinical practice.

Purpose of the Study:

• To evaluate the effectiveness and safety of frequently used agents for otomycosis eradication.
• To compare the efficacy of various treatment options through meta-analysis.

Main Methods:

• A systematic literature search was performed across PubMed, Scopus, Web of Science, and Cochrane databases.
• Included 15 randomized controlled trials (RCTs) involving 2309 adult patients with otomycosis.
• Conducted meta-analysis and subgroup meta-analysis on clotrimazole, miconazole, and fluconazole.

Main Results:

• The overall otomycosis eradication rate was 73.6% across all topical therapies.
• Complete eradication rates varied significantly, ranging from 29.0% to 98.3%.
• Adverse effects were infrequent and primarily included otalgia, pruritus, and burning sensations.

Conclusions:

• Topical therapies achieve over 70% complete eradication of otomycosis.
• Clotrimazole is a frequently utilized and effective treatment option.
• Well-designed studies with standardized protocols are necessary to confirm findings and assess ototoxicity.