Otomycosis

• also known as fungal otitis externa 
• fungal infection of the external auditory canal and its associated complications, sometimes involving the middle ear
• extensive and sometimes unnecessary use of antibiotic ear drops for the treatment of otitis media and otitis externa has been linked to the important increase in the prevalence of otomycosis.

Treatment

•  mainstay of therapy for otomycosis is meticulous cleaning of the ear canal and topical antifungal therapy
• Clotrimazole has the greatest zone of inhibition for common fungi
• appears to be one of the most effective agents for the management of otomycosis, with a reported rate of effectiveness that varies from 95% to 100% in most studies
• clotrimazole 1% solution, applied twice daily for 10 to 14 days, and then reassess the ear canal. If fungal elements are identified, the ear canal should again be meticulously cleaned and undergo a further 10 to 14 day course of topical antifungal with reassessment thereafter
• Oral antifungals may be used in refractory cases. Intravenous antifungals are reserved for patients suspected of having invasive otomycosis

References:

1. www.uptodate.com
2. https://www.academia.edu/730001/Ototopical_antifungals_and_otomycosis_a_review
3. http://www.aafp.org/afp/2012/1201/p1055.html