Black fungus: Amphotericin B, the new oxygen as SOSs ring out

NEW DELHI: Delhi government is now regulating the sale of Amphotericin B, a drug used to treat black fungus, to prevent hoarding. But city hospitals are struggling to procure the suddenly in-demand drug.
A doctor from a private hospital drew parallels between the recent oxygen crisis and the lack of Amphotericin. “We have the drug today but we don’t know whether we will have it tomorrow,” the doctor said. What is worrying is that most experts feel the rare fungal infection is only going to increase in the days to come.

The treatment is not helped by a government installed panel approving Amphotericin treatment twice a day because this paperwork delays administration of medicines. “In normal circumstances, if we have the drug we use it immediately. But now, we have to undertake the paperwork and get the drug use cleared by the government,” said the doctor.
Dr Shuchin Bajaj, director, Ujala Cygnus Hospital, explained that with the government having taken over the supply of Amphotericin B, hospitals had to apply to the government committee, which decided whether the patient required liposomal Amphotericin B or not.

“Earlier, Amphotericin B was readily available because cases of black fungus were fairly rare,” pointed out Dr Sumit Mrig, ENT head at Max Hospital, Saket. “But with the increase in cases, the government has taken over the regulation of the drug to prevent hoarding, which is good in a way, but replenishing stocks are a bit of a hassle now.”
The paperwork has certainly added to the hospitals’ troubles. “It’s time consuming to fill in patient details on the government portal, and even though the approval panel sits twice a day to decide cases, it still takes a lot of time applying for permission to use Amphotericin B, filling the details and sending a request,” said a doctor. “The government could maybe consider everyday delivery of the drug to a hospital since it would be easier this way to check the usage as well. In severe cases of black fungus infection, time is crucial and the drug should be administered immediately.”

In the past week, reminiscent of the oxygen and Remdesivir scarcities, social media platforms have carried requests for the black fungus drug. With demand hitting the sky, unscrupulous operators are hoarding the drug or selling it at premium rates. Sir Ganga Ram Hospital’s medical director, Dr D S Rana, therefore, felt that the installation of the approval panel was correct, but at the same time “it is challenging”.