Amid the rise of mucormycosis or Black fungus infections among Covid-19 patients, the drug Amphotericin B (Ampho-B) being used to treat patients remained in short supply. Various hospitals in Pune and some districts like Ahmednagar and others in Maharashtra have started reporting a shortage of this drug.
The increase in the number of Black Fungus cases in Pune, with some doctors even admitting to treating five to seven patients per day at a multispecialty hospital, has led to an acute shortage of this expensive drug used to treat the rare fungal infection.
The demand for Liposomal Amphotericin B has shot up due to covid-affected mucormycosis, says Rohit Karpe, treasurer of the Association of Chemists in the Pune district. “Usually, in any hospital, there would be a requirement of up to 100 vials per month prior to Covid-19. However, now the consumption per patient is up to 120 vials. Presently the demand has shot up to 1000-1500 vials from hospitals to various distributors in Pune district,” Karpe said. He added that they were informed that production would be enhanced by companies like Cipla, Bharat Serum, SunPharma, and Mylan.
“Amphotericin B is needed for almost two weeks. This was a drug that was rarely used as we often had only one or two patients in a year. Hence this drug was not produced a lot,” Dr. Parikshit Gogate, consulting ophthalmologist who treats patients at Ruby Hall clinic, D Y Patil medical college and hospital said.
The drug costs approximately Rs 7500 per bottle and a patient may need ten per day and may have to use it for six weeks minimum and there are some patients using it for six months too, says Dr. Aditya Kelkar, director at National Institute of Ophthalmology. “I have seen five cases so far but mostly they are referred to neuro ENT infection control specialists who are located at one place in a multi-specialty hospital,” he added.
Dr Ramesh Murthy, an eye surgeon at Deenanath Mangeshkar hospital which has treated a maximum of covid affected cases of mucormycosis admitted to a shortage and said that while alternative drugs like posaconazole and isavuconazole can be given the drug of choice is amphotericin b.
The state FDA has been monitoring the availability of this key drug which has started becoming scarce.