The effect of silver nitrate versus clotrimazole in treatment of otomycosis

Otomycosis is a medical condition defined as the epithelial infection of the external auditory canal caused by yeast cells and filamentous fungi, and constitutes about 9% of external otitis. The purpose of this research was to critically compare the outcomes of topical application of silver nitrate gel 0.2% versus clotrimazole cream 1% in the management of otomycosis and in decreasing the recurrence rate. This prospective comparative study included 200 adult patients with otomycosis attending the Outpatient Clinic of the Otorhinolaryngology Department at Benha University Hospitals. The cases were assigned to 2 equal groups: group (1) managed with silver nitrate 0.2% gel-soaked Gelfoam, and group (2) managed with clotrimazole 1% cream-soaked gauze. Patients were examined with an otoscope. Group (1) had significantly lower edema at 3 days than group (2) (P = 0.018), with no significant difference between both groups at 1 day, and both had no edema at 1 week. At 3 days and 1 week, group (1) had significantly lower pain than group (2) (P = 0.026, 0.043), with no significant difference between the two groups at 1 day. Group (1) exhibited a significantly earlier resolving time and also a reduced recurrence rate than group (2) (P < 0.001, P < 0.001). In the treatment of otomycosis, both clotrimazole 1% cream and silver nitrate gel were effective. Silver nitrate gel was superior to clotrimazole, with earlier resolution and fewer/minimal recurrences.