SYNERGIC EFFECT OF COMBINATION THERAPY FOR TREATMENT OF COVID-19 ASSOCIATED MUCORMYCOSIS

Document Type : Review Article

Authors

1 Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, October 6th University, Giza, Egypt

2 Egyptian Drug Authority (EDA), Giza, Egypt

3 Department of Internal medicine, Faculty of Medicine, Fayoum University, Cairo, Egypt

4 Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt

Abstract

Mucormycosis is an invasive fungal infection that may cause significant morbidity and mortality. The main target organs of mucormycosis infection are the parental sinusitis, orbital cavity, and the brain tissue. It has come to focus during the last few years in context of COVID-19 infection. COVID 19 patients are highly susceptible to fungal infections as they are always immunosuppressed. Prompt eradication of mucormycosis infection by means of anti-fungal therapy in addition to surgical debridement is the standard of care. We questioned if combination antifungal therapy may offer a more effective, yet less toxic, therapy for mucormycosis. We reviewed the literature covering antifungal agents for mucormycosis, whether as monotherapy or in combination. We concluded that combination therapy could be a promising treatment for mucormycosis, particularly in cases associated with COVID-19 infection. This combination could decrease the nephrotoxicity caused by amphotericin B, the main choice in treating mucormycosis, and, on other hand, enhance its therapeutic efficacy.

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