Objectives are to determine antifungal activity of Ivermectin and Calvatiacraniiformis as a novel alternative therapy for aspergillus niger associated acute otitis media (AOM) among rural children of Diyala province; correlation of sociodemographic factors with frequency of infection. Ear swabs taken from 58 infected children and cultured onSabouraud dextrose agar for 7-14 days .Macroscopic and microscopic criteria used for diagnosis of A.niger .High isolation rate for A.niger (27.59%) among children of (4-6) years with significant difference between age groups ( p value 0.039); genders ( p value 0.004);house status(p value=0.018);family size (p value =0.00006334) and month of infection (p value=0.000). A.niger infection negatively correlated with patients age (p value =0.039), family economy and house status (p value =0.000),family size (p value =0.000). Alcohol extract of C.craniiformis (100mg, 200mg, 400mg, 500mg, 600mg, 800mg and 1000 mg) and ivermectin (0.5%,1 % and 2%) restricted the growth of A. niger after 3 days .Significance difference reported between all concentrations except 100 mg and 200 mg ; 600 mg and 800 mg. Significance difference in inhibitory activity between concentration 1% and 2%,0.5% and 2% of Ivermectin respectively. Conclusions: A.niger infections positively correlated with family size and inversely with age and family economy. The growth of A nigersignificantly restricted by alcohol extract of C.craniiformis and Ivermectin in concentration dependent manner. The powerful concentration was 1000mg, for C.craniiformis and 2% for Ivermectin. Thus, C.craniiformis and Ivermectin consider a novel antifungal agents that can be used in clinical practice for treatment of A.niger associated otitis media that represents a clinical problem in children and need serious attention from clinicians.
