Dilemma over black fungus treatment

Scheduled drug is yet to arrive in the districts and taluks

May 26, 2021 03:59 pm | Updated 03:59 pm IST - Belagavi

Black fungus substitute drug

The State government has asked government hospitals at the district and taluk levels to treat mucormycosis or black fungus. Officials, however, are apprehensive of implementing the orders as the scheduled drug is yet to arrive in the districts and taluks.

“The government promised us in early May that doses of Amphotericin B, the drug of choice, will be allocated to districts based on the number of cases. But till Tuesday, we have not got the drugs,” said a Health Department officer in Belagavi district.

P Sunil Kumar, Deputy Commissioner, Vijayapura, said in Vijapura on Monday that doctors in government and private hospitals had started treatment with alternative drugs as the government was yet to ship the prescribed drug. There are 12 cases in Vijayapura and seven cases in Belagavi. There have been two deaths in Belagavi while there is no death in Vijayapura.

The government, as per an order issued on May 23, allowed black fungus treatment in district and taluk hospitals, wherever possible. Earlier, it was allowed only in select hospitals. “However, the government decided to issue Posaconazole in place of Amphotericin B. Hospital-wise allocation, based on admission of black fungus cases, started as per orders issued on May 24. Another officer, who is a member of the district COVID task force, said that the non-allocation may be due to the scarcity of Amphotericin B at the national level.

“We have been told that they are equally useful, but the allocation order does not say anything about efficacy of the drug,’’ said a Health Department officer. While Amphotericin B is scarce, Posaconazole is sufficiently available, the officer pointed out. As of May 25, hospitals in north Karnataka districts have received 310 doses, in proportion to the number of patients they are treating.

Doctors, however, differ. Madhav Prabhu, senior physician who has been treating COVID patients since the first wave, said Amphotericin B would be his first choice as Posaconazole was not found to be equally efficacious, as per internationally accepted treatment protocols. Vasu H.V., physician and coordinator of the Karnataka Covid volunteer network, said the claims of Posaconazole being able to treat black fungus as a substitute drug were partly true, though it was a weaker drug compared to Amphotericin B.

Meanwhile, Belagavi-based Shree Anand Life Sciences has got a licence to manufacture Amphotericin B. The State government has accorded requisite permits to the factory to produce the drug, said a release by the company. “The factory is expected to start full production and the question of supply will be addressed to a significant extent,’’ Deputy Commissioner M.G. Hiremath said.

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