Головна Undefined

ENT 1.4 Malignant otitis externa - Aspergillus spp.

Content version
U-58.2
Updated
10/20/2025 - 15:00

Recommendations

≥ 18 years
Дозування Ремарки
voriconazole oral loading dose 400 mg, twice daily for 1 day

followed by

voriconazole oral 200 mg twice daily

Combine local treatment with systemic therapy

Comments

Local treatment

  • Voriconazole drops 10 mg/ml (1%) 3 drops, three times daily

Before starting local treatment

  • Remove debris
  • Contact the pharmacy to order voriconazole ear drops
  • In case of cavity formation, apply voriconazole drops on a wick
  • If necessary, adjust the choice of antifungal therapy based on susceptibility testing

Treatment duration at least 4 weeks, followed by follow-up at a multidisciplinary mycology meeting (clinical microbiologist, ENT specialist, pharmacist, infectious diseases physician) based on clinical assessment and imaging

Perform therapeutic drug monitoring during systemic use of voriconazole (see this SWAB booklet under Other, TDM antimicrobial agents)