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–sulfamethoxazole Second-line: •Clindamycin + primaquine •Atovaquone •Pentamidine •Trimethoprim + dapsone
Cryptococcus neoformans	Induction therapy: •Liposomal amphotericin + flucytosine Consolidation and maintenance therapy: •Fluconazole Second line: •Posaconazole •Voriconazole
Candida species	First line: •Fluconazole (C. albicans) •Caspofungin (C. glabrata and C. 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 •Isavuconazole 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

^aIntravenous formulation not approved in the UK.