Amphotericin-B: States race against time to procure mucormycosis drug

Karnataka and Maharashtra have both reported a surge in cases of mucormycosis, a disease which happens due to a fungus called mucormycetes which can enter the body through breathing or skin injuries, and has been reported in Covid-19 patients with diabetes or who have been administered steroids.

As the challenge of mucormycosis grips the country, the health ministers of Maharashtra and Karnataka on Friday said that both states are working hard to acquire Amphotericin-B drug which is required for its effective treatment.

A doctor checks a man who recovered from COVID-19 and now infected with black fungus at the Mucormycosis ward of a government hospital in Hyderabad. (AP Photo/For Representative Purposes Only)

Karnataka and Maharashtra have both reported a surge in cases of mucormycosis, a disease which happens due to a fungus called mucormycetes which can enter the body through breathing or skin injuries, and has been widely reported in Covid-19 patients. The disease can be fatal if left untreated and requires several vials of Amphotericin-B to be administered to the patient. Experts say high blood sugar and unregulated administration of steroids during Covid-19 treatment increases the risk of contracting the disease.

List of states with Mucormycosis patients. (HT Illustrations)

Pune, which reported a high number of Covid-19 cases, currently has 300 cases of mucormycosis. “Currently, there are more than 300 cases of mucormycosis in Pune, which also includes people of other districts. We are facing a shortage of injections for these patients. If there are 300 patients, we will need more than 1800 injections per day which is not available in the required numbers,” Maharashtra deputy chief minister Ajit Pawar was quoted as saying by news agency ANI.

He also highlighted that patients require 6 injections a day and said that the state will include its treatment in Mahatma Jyotiba Phule Jan Arogya Yojana. He also said that health minister Rajesh Tope asked the Prime Minister to ensure adequate injections are released to treat patients.

According to the treatment protocol, when Mucormycosis infects the nose, sinus or palate, doctors will administer a 5mg dose per kilogram (kg) of body weight. For example, if a person weighs 60kgs, he would require 300mg of the dose. Each vial has 50mg of the drug. Hence, a patient suffering from the disease will require six vials which costs ₹60,000 on a daily basis. If the infection reaches the brain, doctors have to administer 8-10mg per kilogram of the patient’s body weight, according to a report by HT.

Maharashtra currently has 1,500 cases of mucormycosis and 90 deaths have been reported due to the deadly fungal disease.

Karnataka, which has reported at least 97 cases of mucormycosis, is also taking measures to contain the disease. Deputy chief minister Dr. Ashwathnarayan CN said that the state is working hard to procure Amphotericin-B. “Based on the number of Mucormycosis cases, we are trying to procure Amphotericin-B drug to address the demand. The allocation of the drug by the Centre will be done based on the number of cases in Karnataka,” the deputy chief minister was quoted as saying by news agency ANI. Karnataka chief minister later on Friday said that the government hospitals will treat mucormycosis patients for free, according to news agency ANI.

Prime Minister Narendra Modi in a meeting held earlier today with frontline workers from his constituency highlighted the need of taking precautionary measures against the disease. He also said that amid the battle against Covid-19 second wave, Mucormycosis has arisen as a fresh challenge.