Drug Utilization Study in Patients with COVID-19 Associated Mucormycosis in a Tertiary Care Hospital, South India

ABSTRACT

COVID-19 associated Mucormycosis (CAM) is a serious condition in India considering its unprecedented surge due to COVID-19 and associated high morbidity and mortality. Diabetes and widespread usage of steroids in a background of COVID-19 appear to increase the risk of CAM exponentially. Management includes control of the underlying disease or risk factor, strict glycemic control, surgical debridement of necrotic infected tissue, and specific antifungal therapy. First-line antifungal treatment consists of intravenous liposomal Amphotericin-B (LAB) or deoxycholate Amphotericin-B (AMB) and second-line antifungals are intravenous (IV) or oral Posaconazole (POS) which can also be used as salvage therapy. This study is conducted to observe the drug utilization pattern in CAM patients in tertiary care hospital in South India. A prospective, observational study of 55 patients admitted with CAM are studied in terms of drug usage. POS (98.2%) is the most used drug followed by intravenous AMB (49.1%). POS-Oral are used in 83.6 %, POS-IV in 49.1% and AMB-retrobulbar is used in 12.7% of the patents and average doses are within recommended limits. Anti-bacterial and other antifungal are used in 12.7% and 1.8% of the patients respectively, and 34.5% underwent debridement surgery. Though LAB is the recommended 1st line treatment, AMB and POS are used as a reasonably accepted alternative. Guidelines and recommendations should consider cost, compliance (availability ot oral formulations), safety profile, and accessibility aspects which suit the needs of Low-and middle-income countries (LMIC) especially during an unprecedented event like COVID-19 and CAM. Copyright © 2022, Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.