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Pharmacological treatment, adversities, and mobile-based post-discharge follow-up of mucormycosis survivors in Central India: strengthening patient care

Year: 2026

Type: article

Abstract: Introduction Mucormycosis, a significant post-COVID-19 complication, is stimulated by uncontrolled diabetes mellitus (DM), prolonged corticosteroid exposure, or immunosuppression. Despite clinical advancements, survivors experience long-term challenges; however, follow-up is often missing from treatment strategies, highlighting a critical gap in safeguarding survivors’ long-term well-being. Objective To analyze pharmacological management, adverse events, and post-discharge outcomes among rhino-orbital cerebral mucormycosis (ROCM) patients using medical records and Mobile-Based Post-Discharge (MBPD) follow-up, to inform future clinical and follow-up practices. Method Clinical data of confirmed ROCM inpatients (2021) at two COVID-19-dedicated hospitals in Central India were extracted from medical records and analyzed. Mucormycosis survivors were followed up in 2023 using the MBPD questionnaire to explore overall treatment, post-discharge adversities, and outcomes. The clinical findings and patient-reported experiences were summarised descriptively. Factors associated with adversities were examined using multivariable Firth-penalized logistic regression. Results Among 108 mucormycosis patients, DM was present in 32% of inpatients. Liposomal amphotericin B (71%) and posaconazole (75%) were predominantly prescribed. Access (40%), Watch (39%), and Not Recommended antibiotic combinations (13%) were most prescribed. An average of 1.3 adverse drug reactions were recorded among 73 inpatients. Of 97 survivors, 36 were non-responders. Eighty could be contacted, and 61 (76%) consented to participate in MBPD follow-up. Fifty-two of 61 respondents reported 123 post-discharge adversities, averaging 2.4 adversities per patient, including 9 (7%) deaths confirmed by family members. Antifungal prescription was significantly associated with adversities (aOR 5.82, 95% CI 1.56−21.71; p = 0.009), whereas older age (>60 years) showed a borderline association. Respondents appreciated the follow-up calls and emphasized regularizing them. Conclusion Liposomal amphotericin B, posaconazole, and antibiotics were the most prescribed drugs. DM was the most common comorbidity, highlighting the need for careful monitoring. Antifungal prescriptions were significantly associated with adversities, suggesting the need for implementation of a contextual drug-use policy. The MBPD follow-up was well received and may help monitor recovery, identify health needs, and support the care of survivors of chronic diseases in the future. Survivor-centred care models are suggested to support post-discharge recovery and multidimensional challenges.

Source: Frontiers in Health Services

DOI: 10.3389/frhs.2026.1911647

Authors: Ruchi Baghel, Preeti Acharya, Anshu Verma, Megha Sharma

Institutions: Ruxmaniben Deepchand Gardi Medical College, Karolinska Institutet

Language: English

Topic: Antifungal resistance and susceptibility

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,077