E-Paper
Amphotericin B shortage in Lucknow’s private hospitals makes doctors fall back on other anti-fungal treatment options
The lack of amphotericin B injections for the treatment of black fungus in private hospitals has prompted doctors to use other anti-fungal options, which are not as broad spectrum as amphotericin B
The lack of amphotericin B injections for the treatment of black fungus in private hospitals has prompted doctors to use other anti-fungal options, which are not as broad spectrum as amphotericin B.
“Anti-fungal drugs are available in different categories. Amphotericin B is first choice and covers almost all the types of fungal infection. But if not available, there are other anti-fungal injections being used,” said Dr RK Mishra of SIPS hospital where 12 black fungus patients have recovered till now.
“Ten patients recovered without amphotericin B, while two managed amphotericin B on their own. However, those given other options took a longer time to recover. But they recovered,” said Dr Mishra.
Dr Farookh Ansari, medical director of Chandan hospital, another private hospital treating black fungus patients, said instead of waiting for amphotericin B, other options were used on patients. Chandan hospital has treated over a dozen black fungus patients.
Amphotericin B is in short supply in the private sector while government-run medical colleges treating black fungus cases have an adequate stock. Hence, doctors in the private sector are using alternatives to save lives.
“We use amphotericin B as it covers all types of fungal infections. It takes 28 days to get a fungal culture report. Hence, instead of waiting, we start other available anti-fungal treatment options. In several cases it has worked.”
“The injection amphotericin B has been found most effective in black fungus cases. hence it is the preferred one. But if not available, the other options can be used instead of waiting,” said senior plastic surgeon Dr Vaibhav Khanna, director of Healthcity hospital.
Dr Ved Prakash, head of the department of pulmonary critical care medicine at King George’s Medical University, said, “Posaconazole has also been used in black fungus cases. Instead of injection amphotericin B, which is considered to cover maximum fungal infections, the alternatives can also work among black fungus patients.”
Who’s at risk?
Covid patients with prolonged hospital stay on oxygen support having comorbidity such as diabetes were at the risk of getting black fungus, said doctors.
“Covid induced poor immunity contributes 50% while history of uncontrolled diabetes where patients are irregular in monitoring of their sugar levels and also fail to take the prescribed medicine regularly, contributes to another 30% getting the black fungus infection. Those who develop high sugar during Covid treatment due to use of steroids are also at risk,” said Dr RK Mishra of SIPS hospital.
At times, Covid-induced hypoglycaemia too causes poor immunity for getting infected, said Dr Mishra who has treated 14 black fungus patients.
“I do not agree with the theory that only prolonged oxygen support is responsible for black fungus infection. Two patients I treated never needed oxygen support,” he said.
