Adverse Drug Reactions to Antifungals Used in the Management of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis
Smrati Tiwari1, Zahaan Vakil1★★ Corresponding author
- 1Department of General Medicine, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India.
CORRESPONDENCE
Zahaan Vakil
Department of General Medicine, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra 400012, India.
Received: 14-02-2022; Revised: 02-05-2022; Accepted: 08-05-2022.
Volume 13, Issue 2 · pp. 197–202 · PUBLISHED 2022 · DOI: 10.1177/0976500X221105759
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ABSTRACT
Objectives: To determine the incidence and frequency of adverse drug reactions (ADRs) to find out factors, if any contributing to the same, while also exploring the use of amphotericin B deoxycholate as a cheaper and safe alternative to liposomal amphotericin B. Materials and Methods: It was a cross-sectional observational study, with a study population of 50 conducted over three months after ethics approval. All adult patients admitted to a tertiary care center, in a metropolitan city of Maharashtra, diagnosed with Rhino-orbito-cerebral mucormycosis, with a history of previous COVID-19 infection and receiving antifungals for the treatment of the same were included in the study. Central Drugs Standard Control Organization (CDSCO) ADR reporting forms were used to collect data. Results: Electrolyte disturbances mainly hypokalemia were the most frequently encountered ADR with both Amphotericin formulations (39/50; 20.31%) followed by pain at the injection site (33/50; 17.19%). Nephrotoxicity occurred slightly more frequently with Amphotericin B Deoxycholate (19/29; 65%), compared to Liposomal Amphotericin B (11/19; 57%), while Posaconazole was mainly associated with gastrointestinal (GI) disturbances and hepatotoxicity. Conclusion: Amphotericin B Deoxycholate was associated most with ADRs, hypokalemia, and pain at the injection site being the most frequent. However, concerning nephrotoxicity, both Amphotericin formulations showed only a modest difference. Posaconazole was associated with the least number of ADRs and had a favorable safety profile.
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Tiwari, S., & Vakil, Z. (2022). Adverse Drug Reactions to Antifungals Used in the Management of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis. Journal of Pharmacology and Pharmacotherapeutics, 13(2), 197–202. https://doi.org/10.1177/0976500X221105759