Deoxycholate amphotericin for management of mucormycosis: a retrospective cohort study from South India

Document Type

Article

Publication Title

Infezioni in Medicina

Abstract

Introduction: Liposomal amphotericin use is limited in developing countries due to its extremely high cost and availability. Therefore, the study aimed to evaluate deoxycholate amphotericin B’s utility and adverse effect profile in patients with mucormycosis. Methodology: This retrospective cohort study from 2019 to 2021 included patients with proven mucormy-cosis who received deoxycholate amphotericin B for more than or equal to five days and had at least three creatinine values on treatment. Baseline demographic details, risk factors and treatment details of all the patients were recorded. In addition, the details of treat-ment-related adverse effects and outcomes were ascer-tained. Results: Of the 57 included patients, a history of diabe-tes, COVID-19 and steroid use was present in 49 (86%), 43 (75.4%) and 33 (57.9%) patients, respectively. Isolat-ed rhino-orbital mucormycosis was the most common presentation (n=49, 86%). The median time of fol-low-up was 48 (30.5-90) days. A total of 8 (14%) pa-tients died during the hospital stay. The median dura-tion of amphotericin treatment was 21 (14-40) days. Thirty-nine patients (68.4%) developed hypokalaemia on treatment, while 27 (47.4%) patients developed hy-pomagnesaemia. A total of 34 (59.6%) patients developed AKI on treatment. The median day of development of AKI was 6 (4-10) days. The median baseline, highest and final creatinine values were 0.78 (0.59-0.94) mg/dl, 1.27 (0.89-2.16) mg/dl and 0.93 (0.74-1.59) mg/ dl respectively. The median percentage change from baseline to highest value and last follow-up value was 45% (0.43%-161%) and 25% (-4.8%-90.1%) respectively. The final creatinine was less than 150% of the baseline in 36 (63.2%) patients. Conclusion: Deoxycholate amphotericin is an accept-able alternative for treating mucormycosis in re-source-constrained settings.

First Page

432

Last Page

439

DOI

10.53854/liim-3003-12

Publication Date

1-1-2022

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