amphotericin-b and Ear-Diseases

Fungi, in comparison with other pathogenic factors, have high pathogenicity. The number of fungal species which are able to infect people is over 500. The upper respiratory tract and ear have permanent contact with external environment which makes their ontocenoses open to continuous exchange of microorganisms of which they consist. In etiology of inflammatory processes 21 species which belonging to 3 genera (Zygomycota, Ascomycota, Basidiomycota) of fungi play important role. Administration of antifungal drugs can be: prophylactic, empiric preemptive and therapeutic. Physicians may prescribe antibiotics (mainly pollens: amphotericin B, natamycin and nystatin) and chemiotherapeutics (mainly azoles and fluorpirymidins, pigments, chlorhexidine and chlorquinaldol). In ENT practice topical and systemic drugs can be administrated. Topical lozenges include amphotericin B, clotrimazole, chlorhexidine or chlorquinaldol and oral gels: nystatin and miconazole. Some of drugs are in the form of suspension/solution, which can be used for inhalation, into the sinus, for swabbing or for lavage: amphotericin B, natamycin, nystatin, clotrimazol, flucytosine, miconazole, fluconazole, vorykonazole, caspofungin. It should be underlined that only a few of dugs can be absorbed from the digestive tract: flucytosine, fluconazole, itraconazole, ketoconazole, miconazole, vorykonazole.

Topics: Administration, Inhalation; Administration, Oral; Administration, Topical; Amphotericin B; Antifungal Agents; Azoles; Clotrimazole; Ear Diseases; Humans; Miconazole; Mycoses; Nystatin; Otitis; Respiratory Tract Infections

Topics: Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Biopsy; Diagnosis, Differential; Drug Therapy, Combination; Ear Diseases; Female; Humans; Ketoconazole; Leishmaniasis, Cutaneous; Middle Aged; Plant Extracts; Wounds, Nonpenetrating

Otomycosis is worldwide in distribution and most commonly caused by Aspergillus species. Amphotericin B, itraconazole and voriconazole are used for the treatment of aspergillosis, but recently an increase in resistance to these agents has been reported. We aimed at investigating the in vitro activities of amphotericin B, voriconazole and itraconazole against Aspergillus isolates causing otomycosis. Mycological analysis of samples from the ear canals of patients was performed by culturing onto Sabouraud Dextrose Agar and by evaluating microscopically. Aspergillus species were identified with colony morphology and microscopic appearance, and tested for susceptibilities to amphotericin B, itraconazole and voriconazole by the CLSI reference broth microdilution method (M38-A document). A total of 120 isolates from 120 patients, comprising 57 Aspergillus niger, 42 Aspergillus fumigatus, nine Aspergillus flavus, six Aspergillus nidulans and six Aspergillus terreus strains were tested. No resistance was determined against amphotericin B and voriconazole, while six A. fumigatus and three A. niger isolates were resistant to itraconazole. In vitro data obtained in this study showed the resistance to itraconazole, while all of the isolates were susceptible to voriconazole and amphotericin B. Voriconazole seemed to be an alternative in the treatment of infections related to Aspergillus spp. but further studies are needed to learn more about the antifungal resistance of different species of Aspergillus to different agents.

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Aspergillus; Drug Resistance, Fungal; Ear Diseases; Humans; Itraconazole; Microbial Sensitivity Tests; Pyrimidines; Triazoles; Voriconazole

Topics: Adult; Amphotericin B; Chromoblastomycosis; Ear Diseases; Ear, External; Humans; Male

The course and treatment of two patients with otomycosis due to Coccidioides immitis, believed to be the first such cases reported, are described. Both infections appeared due to reactivation of hematogenously disseminated foci. Local and systemic chemotherapy plus surgery resulted in remission, and host immune response also appears to be an important factor. One patient, with systemic lupus erythematosus, required more extensive surgery, more chemotherapy, and reduction in steroid dose to arrest the disease. A combined surgical and chemotherapeutic approach appears necessary when otomycosis is due to invasive fungi such as C immitis.

Topics: Adult; Amphotericin B; Coccidioidomycosis; Debridement; Ear Diseases; Female; Humans; Male

Topics: Amphotericin B; Aspergillosis; Aspergillus; Ear Diseases; Female; Humans; Middle Aged

Topics: Amphotericin B; Animals; Ear; Ear Canal; Ear Diseases; Humans; Infections; Sheep; Sheep, Domestic; Wool