As cases of mucormycosis surge and supplies of liposomal amphotericin B, a drug used to treat it, fall short, a newer and cheaper alternative has emerged as the choice for several doctors in Maharashtra.
Doctors are now using conventional amphotericin B instead of liposomal amphotericin B. While the latter costs Rs 30,000 daily for a 25-day course, the former costs about Rs 9,000 for the same treatment. Doctors say that although it costs a fraction of the drug, it is able to provide equal results.
However, the conventional variant causes a lot of side-effects like nausea, headaches and kidney impairment. It also has to be carefully administered intravenously over 16 hours. Compared to that, liposomal amphotericin B is given as a six-injection daily course.
With an acute shortage of the liposomal variety, it is being reserved only for the most serious cases, say doctors in Mumbai.
On Friday, the BMC received 2.000 injections of liposomal amphotericin B from the state FDA and has distributed it to patients in both civic and private hospitals. 1 lakh injections have been demanded but supply remains scarce.
State Health Minister Rajesh Tope said, “Maharashtra has already placed orders for 50,000 doses of the injection with Caron and 60,000 doses with AIG Lifesciences.” However, according to Tope, these companies will be able to supply the needed injections to the state only after May 31.
“Maharashtra would require 2 lakh injections of amphotericin B. The state has already ordered 1.9 lakh amphotericin B injections from various manufacturing companies but these are not being delivered yet, as the supply is regulated by the central government, he added.
Maharashtra will also source raw materials or Active Pharmaceutical Ingredients (API) to produce the amphotericin B injections in the state. The state has also released a 9-page treatment guideline for mucormycosis.
The main treatment for mucormycosis is surgery, says Dr. Ajay Doiphode, President, Mumbai ENT Association. “Black Fungus is an opportunistic infection. It’s a pro-diabetic kind of a stage which drags a person who is low on immunity to get diabetic. The main reason behind getting infected is low immunity due to Covid and lack of hygiene. Due to an excessive use of steroids, which is dangerous for patients, cases have increased too,” he said.
After the first case of mucormycosis was detected in the third week of April, Maharashtra has recorded a staggering 1,500 cases till date. There have been 100 deaths due to the fungal disease so far. On May 21, thestate declared it as a Notifiable Disease under the Epidemic Diseases Act, making it compulsory to report each case of the infection to the state health department.