Surge of Post-COVID Fungal Infections in India: Causes & Prevention

[Wrichik Basu]

TL;DR

Can low doses of antifungal drugs like fluconazole (i.e. something other than Amphotericin-B) help in preventing fungal infections in COVID survivors?

In India, we are facing a surge of post-COVID fungal infections. The most widespread is Mucormycosis (aka black fungus). There has also been a number of cases of white fungus (probably the existing disease Candidiasis, as per this article), and a yellow fungus (anyone knows the medical term for this one?) has also made its way to the headlines. Today, I found this article that reported eight patients have been tested to have Aspergillosis. Amphotericin-B is being used to treat almost all the above infections.

The main reason for the surge of these fungal infections is the weakened immune system of people surviving COVID-19, and also an increased use of steroids in hospitals. People with diabetes are more prone to Mucormycosis as per many reports.

Steroids are often known to cause fungal infections as side effects. (My mother, for instance, has COPD, and our doctor has advised her an inhaler that is a combination of formoterol (a bronchodilator), and budesonide. But she cannot take it regularly because after taking it for some consecutive days, a fungal infection develops in her throat, and her voice cracks. That is when she switches to a non-steroid inhaler containing levosalbutamol and ipratropium bromide.)

My question: Can low doses of antifungal drugs like fluconazole (i.e. something other than Amphotericin-B) help in preventing these infections? Maybe doctors can prescribe them to people who have been treated with steroids, or those who may have low immunity or diabetes. Has any study been done on this?

 

[OmCheeto]

Summary:: Can low doses of antifungal drugs like fluconazole (i.e. something other than Amphotericin-B) help in preventing fungal infections in COVID survivors?

In India, we are facing a surge of post-COVID fungal infections. The most widespread is Mucormycosis (aka black fungus). There has also been a number of cases of white fungus (probably the existing disease Candidiasis, as per this article), and a yellow fungus (anyone knows the medical term for this one?) has also made its way to the headlines. Today, I found this article that reported eight patients have been tested to have Aspergillosis. Amphotericin-B is being used to treat almost all the above infections.

The main reason for the surge of these fungal infections is the weakened immune system of people surviving COVID-19, and also an increased use of steroids in hospitals. People with diabetes are more prone to Mucormycosis as per many reports.

Steroids are often known to cause fungal infections as side effects. (My mother, for instance, has COPD, and our doctor has advised her an inhaler that is a combination of formoterol (a bronchodilator), and budesonide. But she cannot take it regularly because after taking it for some consecutive days, a fungal infection develops in her throat, and her voice cracks. That is when she switches to a non-steroid inhaler containing levosalbutamol and ipratropium bromide.)

My question: Can low doses of antifungal drugs like fluconazole (i.e. something other than Amphotericin-B) help in preventing these infections? Maybe doctors can prescribe them to people who have been treated with steroids, or those who may have low immunity or diabetes. Has any study been done on this?

I believe the keyword you need to research this is "prophylaxis".

google: fluconazole as antifungal prophylaxis

I suspect forum rules prevent anyone from answering your question in an authoritative kind of way.

My own experience with fluconazole was that it eliminated whatever fungus I had within a day.
Unfortunately, I have not a clue what that fungus was, and google says it's useless against the "black" one.

I've never considered using it prophylactically, as that's like casually taking antibiotics, which leads to super bugs.