Recommendations Comments Local treatment Voriconazole drops 10 mg/ml (1%) 3 drops 3 times daily for 14 days If the ear canal is swollen, apply voriconazole drops to a wick If the ear canal is open, do not use a wick Before starting local therapy Remove debris Contact the pharmacy to order voriconazole ear drops If necessary, adjust the choice of antifungal therapy based on known susceptibility testing In chronic otitis externa and mixed infection, first treat the underlying bacterial infection There are no data on ototoxic adverse effects of voriconazole ear drops in a perforated tympanic membrane If using voriconazole ear drops with a perforated tympanic membrane, stop treatment if tinnitus, vertigo or acute hearing loss occur
Local treatment
Before starting local therapy