Adjunctive Use of Saturated Solution of Potassium Iodide (SSKI) With Liposomal Amphotericin B (L-AMB) in Mucormycosis Achieves Favorable Response, Shortened Dose and Duration of Amphotericin: A Retrospective Study From a COVID- 19 Tertiary Care Center

Background: Second wave of COVID-19 pandemic was associated with an unprecedented rise in cases of mucormycosis, treatment of which has been challenging owing to the availability and side effects associated with amphotericin.Methods: All patients presenting with rhino-orbital cerebral mucormycosis (ROCM) following COVID-19 infection between April 2021 to June 2021 were included in this retrospective interventional study. Primary objective was to assess the clinical response with combination of intravenous liposomal amphotericin B (4-5 mg/kg/day) and saturated solution of potassium iodide (SSKI) given orally along with surgical debridement. Results: Twenty-five patients of ROCM were treated with the regimen. Mean age and fasting blood sugar levels were 53.48 years and 239.64 mg/dl respectively. All patients had history of intake of steroids with a mean daily dose of 86.39 mg of prednisolone equivalent. 88% of patients had a “proven” diagnosis of mucormycosis. Cultures were positive in 52% of patients with Rhizopus arrhizus as the predominant species. The mean daily dose of amphotericin received was 268mg/day with a mean duration of 9.52 days. Mean daily dose of SSKI was 2.57 grams. 21 patients (84%) had stabilization of disease at week 8 and achieved cure at the end of treatment whereas the mortality rate was 16%. Factors that significantly affected outcome were underlying lung disease and eye involvement on presentation. Interpretation: SSKI, with its remarkably low cost and safety profile, makes it a potential adjuvant drug that may help achieve the twin benefits of shortened duration and dose of LAMB. Funding Information: No sources of funding.Declaration of Interests: No conflict of interest.Ethics Approval Statement: Approval for analyzing the hospital data was taken from the Institutional Review Board (IRB).