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. 2016 May 5;44(6):378–383. doi: 10.1016/j.mpmed.2016.03.015

Table 3.

Antifungal treatment choices

Fungal pathogen Treatment
Aspergillus species First-line:

  • Voriconazole ± caspofungin

  • Lipid formulation of amphotericin

Second-line:

  • Posaconazolea

  • Itraconazole

  • Isavuconazole

  • Caspofungin

  • Anidulafungin
Pneumocystis jirovecii First line:

  • Trimethoprim–sulphamethoxazole

Second-line:

  • Clindamycin plus primaquine

  • Atovaquone

  • Pentamidine

  • Trimethoprim plus dapsone
Cryptococcus neoformans Induction therapy:

  • Liposomal amphotericin plus flucytosine

Consolidation and maintenance therapy:

  • Fluconazole

Second line:

  • Posaconazole

  • Voriconazole
Candida species First line:

  • Fluconazole (Can. albicans)

  • Caspofungin (Can. glabrata, Can. krusei)

Second line:

  • Voriconazole

  • Itraconazole

  • Posaconazolea

  • Micafungin

  • Amphotericin
Non-Aspergillus filamentous fungi (e.g. Fusarium, Zygomycetes, Scedosporium, Penicillium) Consider surgical debridement
First line:

  • Liposomal amphotericin

Second line:

  • Posaconazole
Endemic fungi (Histoplasma, Coccidioides, Blastomyces, Sporothrix) First line:

  • Mild disease immunocompetent: no treatment (Histoplasma), itraconazole (others)

  • Moderate disease: itraconazole

  • Severe disease: amphotericin

Second line:

  • Posaconazole

  • Voriconazole

  • Fluconazole
a

Intravenous formulation not approved in the UK.