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COVID-19: Karnataka faces shortage of mucormycosis drugs

The increase in mucormycosis cases has become an added concern for Bengaluru

hospital-icu-kozhikode-pti Representational image | PTI

Karnataka faces a dire shortage of drugs used to treat Mucormycosis, amid surge in fresh cases.

“Standard of care is liposomal Amphotericin B. Karnataka is running short of the drug. Each patient needs minimum of 4 vials of 50 mg each a day for at least 10 to 12 days. Hospital pharmacies are running out of stock and stocks are not coming,’’ said Dr Roshmi Gupta, head, Orbit and Oculoplasty Services, Narayana Nethralaya, Bengaluru.

To ensure availability of Amphotericin B, the Government of India is taking various steps including ramping up domestic production of the drug and improving exports.

Mucormycosis is a fungal infection that can become life threatening. “The circumstances of weakened immunity due to the virus, with a background of uncontrolled diabetes and malignancy and various medications contribute to the conducive environment for the fungus to take advantage and cause sinusitis and eye involvement which may be debilitating. The infection can also involve the brain and sepsis,’’ explained Dr Srivatsa Lokeshwaran, Consultant - Interventional Pulmonology, Aster CMI Hospital, Bengaluru.

People with uncontrolled diabetes, transplant recipients (liver/kidney),  those with liver failure, haematological cancers, and weakened immune systems are at an increased risk for Mucormycosis. Dr. Manjunath Malige, chief endocrinologist and diabetologist at Aster RV Hospital, Bengaluru attributes the rise in cases of Mucormycosis to the use of steroids for the management of COVID-19.  “Asymptomatic Covid infections will need to be treated with steroids, and as steroids increase sugar levels, this particularly increases the risk of black fungus infection. High ferritin levels in the blood and usage of unrationalised antibiotics can also lead to this infection.’’ 

There has been a marked increase in the incidence of mucormycosis in Karnataka. The increase in mucormycosis cases has become an added concern for Bengaluru, which has emerged as India’s Covid capital. The city has logged around 9.75 lakh COVID-19 cases.

Finding care for mucormycosis is very difficult, said Gupta.  Patients may have to occupy bed for three weeks. “Because of the central distribution of beds, they may not get one at an appropriate centre if they are Covid positive. Big  hospitals are running out of non-Covid beds and have no control over allotment of Covid beds,’’ she said.

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