Use of Any Form of Amphotericin B Alone or with Posaconazole in COVID-19 Associated Mucormycosis (CAM) at the Time of Pandemic Disaster in a Tertiary Care Teaching Hospital.

BACKGROUND

The recent COVID-19 wave showed a significant rise in mucormycosis, changing its prevalence, particularly in India. Sadly, the total risk of mortality due to COVID-19 associated mucormycosis (CAM) remains high. It may be better to introduce a combination of drugs rather than unacceptable poor outcomes with Amphotericin B monotherapy.

AIM: The aim of this study is to assess the proportion of mucormycosis patient's clinical outcomes with antifungal agent (Amphotericin B of any forms alone) or combination drug therapy (Amphotericin B of any form and Posaconazole).

METHODS

It was a retrospective cohort study conducted between April 1st, 2021 and July 31st, 2021 at the tertiary care teaching hospital All India Institutes of Medical Sciences (AIIMS), Raipur.

RESULTS

Out of 271 medical records of CAM patients, 211 records were included in the study. Among them, 46 patients (21.8%) received group 1 treatment i.e. Amphotericin only and 165 patients (78.2%) received group 2 treatment, i.e. Amphotericin B with Posaconazole. Group 2 was associated with a longer time to event, having a higher survival rate. The Hazard Ratio (HR) was 0.22 (95% CI - 0.13-0.36, p-value 0.000).

CONCLUSION

Our findings will support the need for future studies to determine the efficacy of AMB and posaconazole combination therapy in the treatment of mucormycosis and to produce an evidence-based standard treatment regimen.