Publication:

Study of mucormycosis patients attending tertiary care hospital: a retrospective study

Background Treatment of mucormycosis involves a combination of surgical debridement of involved tissues and antifungal therapy. Intravenous amphotericin B is the drug of choice. In this study authors assessed the outcomes of treating patients with mucormycosis with varied formulations of amphotericin.

Methods Authors performed a retrospective observational study of patients diagnosed with mucormycosis and admitted in the inpatient ward of Bharati Hospital, Sangli, Maharashtra, India from May 2015 till May 2018. Patients either received amphotericin B, lyophilized amphotericin B or lipid soluble amphotericin B. Resolution of symptoms was graded as good clinical response and persistence of symptoms as poor clinical response.

Results During the study period a total of 16 patients were included in the study. All patients underwent surgical debridement and received different forms of amphotericin. Three patients received amphotericin B 1.5 to 3 grams over 21 days and responded satisfactory and later had renal toxicity. Five patients received lyophilized amphotericin B 3 to 4 grams over 21 days, with good response and less renal toxicity as compared to amphotericin B. Lipid soluble amphotericin B was given to 8 patients 3.5 to 5 gm over 21 days with good clinical response and minimal renal toxicity. Of the 10 patients who presented with nasal discharge, 60% had a good clinical outcome, 30% had poor and one patient died.

Conclusions Amphotericin B is an effective anti-fungal. Further studies are needed to assess the utility of immunologic and metabolomic profiling of the host and prescribing targeted immunotherapy in decreasing the incidence of mucormycosis.