Black fungus treatment should start early, drug availability should improve, say doctors
May 25, 2021
By Joymala Bagchi
New Delhi [India], May 25 : With rise in the number of mucormycosis cases in the national capital, doctors have urged caution and said availability of drugs should improve.
Several states and UTs have declared mucormycosis, also called black fungus, as an epidemic under the Epidemic Diseases Act (1897).
Doctors in the city ANI spoke to said there is shortage of Amphotericin drug used to treat the fungus. They said treatment should be early as recovered COVID-19 patients are already weak in their body. The doctors said that factors such as use of steroids in treatment of COVID-19 and co-morbidities can make a patient more vulnerable to black fungus.
The doctors said they anticipated there would be cases of black fungus due to COVID-19 but now there is scarcity of drugs.
Dr Vivek R Sinha, ENT surgeon and Senior Consultant, Venkateshwar Hospital, said treatment may vary according to symtoms of patient.
"We anticipated the rise in mucormycosis based on our experience in the first wave but the sheer number caught us unprepared and drugs for all the cases dealing with the infection were not there. Amphotericin is available in three different forms. Liposomal Amphotericin, a lipid complex version and Amphotericin B deoxycholate (the older version of the anti-fungal). But the older version can cause significant morbidity because it can damage kidneys as most of the patients have diabetes for which Liposomal Amphotericin is preferred," he said.
The cost of Liposomal Amphotericin is on the higher side and is a double whammy for patients who need to take it after recovering from COVID-19.
People may need surgical support because the treatment is effective only after the dead or infected tissue is removed.
"Liposomal Amphotericin cost can be on average rupees Rs 3500 to Rs 8000 per day," Dr Sinha said.
Doctors at several hospitals in the city said there is shortage of drug used to treat black fungus.
Five more manufacturers have been granted a license to make Amphotericin-B by the central government in addition to the existing manufacturers. An additional 1,11,000 vials of Amphotericin-B are expected to be available per month from July this year.
Union Health ministry has reported 5,424 cases of mucormycosis in the country of which 4,556 patients have a history of COVID-19 infection with 55 per cent also having diabetes.
