Efficacy of combination therapy of amphotericin and posaconazole in treatment of mucormycosis

Sridhara  S; Ramesh Sanappa; Nandini P; Gayatri  Jayan; Gangadhara  KS

doi:10.18231/j.joapr.2023.11.1.9.14

Authors

Sridhara S. Department of ENT, Shimoga Institute of Medical Sciences, Shimoga, Karnataka- 577201
Ramesh S. Department of ENT, Shimoga Institute of Medical Sciences, Shimoga, Karnataka- 577201 https://orcid.org/0009-0007-5962-0000
Nandini P Department of ENT, Shimoga Institute of Medical Sciences, Shimoga, Karnataka- 577201
Gayatri Jayan Department of ENT, Shimoga Institute of Medical Sciences, Shimoga, Karnataka- 577201 https://orcid.org/0009-0003-3360-6957
K S Gangadhara Department of ENT, Shimoga Institute of Medical Sciences, Shimoga, Karnataka- 577201

DOI:

https://doi.org/10.18231/j.joapr.2023.11.1.9.14

Keywords:

Mucormycosis, amphotericin B, posaconazole

Abstract

Background: Mucormycosis is an opportunistic systemic fungal infection which is debilitating caused by order Mucorales. The standard management of mucormycosis consists of aggressive debridement of the infected tissue and parenteral anti-fungal therapy with Amphotericin B. Liposomal amphotericin B is a “true” liposomal formulation of amphotericin B with greatly reduced nephrotoxicity and minimal infusion-related toxicity. Very minimal data is available on the usefulness of combining different antifungal agents for an effective outcome. Our study was undertaken at a time when there was a huge turnover of mucormycosis cases during Covid 19 pandemic with resultant shortage of important resources including liposomal amphotericin B. In effect, combination of liposomal amphotericin B with posaconzole gave a promising outcome. Objectives: To study the efficacy of combination therapy of liposomal amphotericin B and posaconazole in the treatment of mucormycosis. Methodology: It is a prospective study of 43 patients with mucormycosis who received combination therapy based on their disease severity. Results: In our study, 16 (37%) were considered as patients with mild disease, 18 (41.8%) were considered as patients with moderate disease and 9 patients (20.9%) were considered as severe. 20 (58%) patients out of 34 patients with mild to moderate disease showed improvement after combination therapy. Conclusion: A significant percentage of patients in our study showed improvement with combination therapy of liposomal amphotericin B and posaconazole in terms of survival and disease recurrence.

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