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The Indian Council of Medical Research (ICMR), today submitted before the Delhi High Court, its advisory on the management and treatment of Mucormycosis (Black Fungus) advocating the use of Amphotericin B deoxycholate for treating Mucormycosis and administration of Liposomal Amphotericin B for patients with nephrotoxicity.

ICMR submitted that Amphotericin B was not the only medication available for treating Mucormycosius and Posaconazole can also be used in case of scarcity of Amphotericin B.

On perusal of the advisory the bench comprising Justices Vipin Sanghi and Jasmeet Singh was of the view that the protocol said that liposomal Amphotericin B is to be administered to those patients who cannot tolerate nephrotoxicity, hence when a doctor would read the guideline, he may conceive that the treatment should begin with Amphotericin B and liposomal be administered only when one’s kidney, heart or brain begins to get damaged.

Dr. Jerin Jose, scientist from ICMR clarified that the advisory is not a standalone advisory but comes with a cover letter which says that it is only for the present situation. Moreover, it was a live advisory which would be revised every 15 days He further submitted that liposomal and Amphotericin B have the same efficacy and the only difference is that liposomal is less toxic but there are other medicines to prevent toxicity which have been highlighted in the advisory. Moreover about 80% of the population in India for about a decade have been treated with Amphotericin B, said Dr. Jose.

He further pointed out that the advisory.

“Liposomal costs more than Amphotericin B and it is in light of these that we have recommended the administration of Amphotericin B first in normal circumstances and for nephrotoxicity liposomal should be preferred…. The formulation does have chances of nephrotoxicity but we do have mentioned how to prevent the nephrotoxicity. We have preferred liposomal for specific patients so that there is no scarcity of medicine”, submitted Dr.Jose.

Advocate Kirtiman for UOI also clarified that Amphotericin B was the base drug and Liposomal Amphotericin B was for the purpose of reducing toxicity.

ICMR assured the bench that the covering letter which mentions that the guidelines have been issued only having regard the to present situation of shortage of Liposomal Amphotericin B, would be added as an addendum to the advisory.

The bench directed the Union and ICMR to adhere to their assurance and include the advisory in the guidelines for treatment of Mucormycosis. The advisory is to be reviewed every two weeks.