loading page

The study of drug utilisation and disease recurrence in patients with COVID Mucormycosis (CAM) on Posaconazole step-down therapy: an ambispective study.
  • +23
  • Zaid Shaikh,
  • Mathan Kumar,
  • Saurav Sarkar,
  • Biswa Padhy,
  • Pradipta Parida,
  • Chappity Preetam,
  • Pradeep Pradhan,
  • Dillip Samal,
  • Ashwin Renith,
  • Aparna Sunil,
  • Akshay Vishnu,
  • Asutosh Adhikari,
  • Vinay Hallur,
  • Anindya Nayak,
  • Srinivas Chadaram,
  • Krishna Das,
  • Swagata Chakraborty,
  • Prity Sharma,
  • Aswathi Veeti,
  • Vinusree K,
  • Abhijeet Mishra,
  • Yash Mittal,
  • Kalyana Chithambaram,
  • Anurita Swarup,
  • Swathi Chenniappan,
  • Anwer Shah
Zaid Shaikh
All India Institute of Medical Sciences - Bhubaneswar

Corresponding Author:[email protected]

Author Profile
Mathan Kumar
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Saurav Sarkar
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Biswa Padhy
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Pradipta Parida
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Chappity Preetam
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Pradeep Pradhan
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Dillip Samal
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Ashwin Renith
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Aparna Sunil
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Akshay Vishnu
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Asutosh Adhikari
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Vinay Hallur
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Anindya Nayak
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Srinivas Chadaram
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Krishna Das
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Swagata Chakraborty
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Prity Sharma
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Aswathi Veeti
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Vinusree K
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Abhijeet Mishra
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Yash Mittal
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Kalyana Chithambaram
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Anurita Swarup
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Swathi Chenniappan
All India Institute of Medical Sciences - Bhubaneswar
Author Profile
Anwer Shah
All India Institute of Medical Sciences - Bhubaneswar
Author Profile

Abstract

Background and Purpose: Invasive mucormycosis is a fatal disease caused by Mucorales species. Treatment therapy for CAM includes aggressive surgical debridement and systemic antifungals in Amphotericin B and Posaconazole as step-down therapy in the follow-up period. Despite being on oral antifungal Posaconazole therapy, patients have been observed to have a recurrence of mucormycosis in the follow-up period. Experimental Approach: An ambispective cohort study was done in the department of ENT and Pharmacology of All India Institute of Medical Sciences (AIIMS), Bhubaneswar, from April 2021 to September 2022. It includes patients on follow-up on the step-down therapy of Posaconazole. Medication adherence was measured based on the half-life of Posaconazole and participants not skipping a single dose. Key Results: The demographic data between the recurrence and non-recurrence groups, including age, sex and duration of stay, was not significant. Recurrence in mucormycosis was not found to be associated with medication adherence. By both methods of calculating medication adherence, the results were statistically insignificant. The difference in onset of recurrence of the disease between the two groups was statistically significant, with a p-value of 0.027 in patients who did not skip a single dose of Posaconazole with a hazard ratio of 3.887. There was a statistically significant difference in cost-effective analysis with a p-value of 0.042 between groups. Conclusion and Implications: Posaconazole medication adherence in the postoperative period does not affect the recurrence of mucormycosis during step-down therapy. However, it helps prolong the onset of disease recurrence in patients adhering to the medication.