Liposomal Amphotericin-B Infusion-related Adverse Effects in Fungal Osteomyelitis of Jaws in COVID-19 Patients: An Institutional Experience

Abstract Introduction: Mucormycosis of the jaws is commonly seen in survivors of COVID-19 due to steroid therapy and diabetes mellitus. Liposomal amphotericin-B (LAmB) is the drug of choice for management. Materials and Methods: A longitudinal study involving 59 patients treated for COVID-19-associated mucormycosis (CAM) of the jaws was conducted at a tertiary hospital. The study’s objective was to monitor the adverse effects during LAmB therapy. The patients underwent surgery and received LAmB. Demographic data, comorbidities, days of hospitalization, facial bone involved, total doses of LAmB, method of vein access, the occurrence of thrombophlebitis, clinical parameters (headache, nausea, vomiting, chills, and fever), and laboratorial parameters (sodium, potassium, chloride, blood urea, and serum creatinine) were recorded for all the patients. All the above-mentioned parameters were tabulated for 5 weeks. A paired t -test was applied to analyze the clinical and laboratory values. Results: Out of 59 patients, 51 were male. Twenty-seven patients were diabetic (type II). There was a significant decrease ( P < 0.05) in sodium and potassium levels and a reduction in the mean number of headache episodes from admission to discharge. Serum creatinine levels were significantly increased. Conclusion: LAmB is the drug of choice in treating CAM of jaw patients. There are significant adverse effects associated with the LAmB infusion despite patients getting accustomed to the drug.