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Surgeons find a way to make mucor care 100 times cheaper | India News

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PUNE: Careful monitoring of blood creatinine levels in patients battling post-Covid mucormycosis can ease the pain of daily drug costs of Rs 35,000 to Rs 350, treating surgeons have found.
While the liposomal form of amphotericin injections, a key anti-infection drug, is prohibitively expensive, the conventional form of the same drug costs 100 times less but must be administered carefully, with a blood test every alternate day to rule out infection. drug toxicity to the kidneys.
If creatinine levels rise, the 21-day drug cycle can be ended with two or three “pit stops,” also called “amphotericin vacations,” to allow the body to normalize. Creatinine is a waste product that is channeled out of the system through the kidneys.
Otolaryngologist surgeon Samir Joshi said “unwarranted” concerns about conventional amphotericin causing kidney damage had led to “over-demand” for the liposomal form of the drug. “We must dispel this fear.”
The effectiveness of both forms of amphotericin is equal, doctors say. The problem is that the drug in its conventional form should not be given to patients with significant comorbidities, such as kidney failure and diabetic ketoacidosis. In the rest, conventional amphotericin can effectively stop the spread of mucormycosis, specialists have found. All a treating physician has to do is strictly monitor blood creatinine levels and cleanse damaged tissue.
“Liposomal amphotericin is undoubtedly safer than conventional amphotericin and everyone would want the safer version. But there is no difference in the efficacy of both forms of the drug, ”said Joshi, head of the department of Otolaryngology at BJ Medical College Pune and Sassoon General Hospital.
He has treated about 201 patients with post-Covid mucormycosis. “More than 85% of these patients recovered successfully through the controlled use of conventional amphotericin and carefully planned debridement surgeries. Your long-term follow-ups will consolidate this success rate. ”
Before the Covid attack, Joshi had treated 65 patients with mucormycosis using conventional amphotericin. “Of these, 63 patients recovered and have survived,” he said.
The combined use of amphotericin and surgery generally works. Surgery removes dead and necrotic tissues. Amphotericin continues to stop the growth of fungi in adjacent living tissue.
ENT surgeon Sandeep Karmarkar said, “Debridement (clearance) of all affected tissues is extremely vital. Only after a complete elimination, the drug will be able to arrive at the place of destination ”.
Currently, neither conventional nor liposomal amphotericin is readily available as supply is limited. “Liposomal amphotericin B is non-toxic, causes fewer electrolyte changes, higher doses can be delivered in a short period of time, and penetration into tissues is better,” he said.



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