Table 3.

Prevention of rhino-orbito-cerebral mucormycosis in the setting of COVID-19

• Judicious and supervised use of systemic corticosteroids in compliance with the current preferred practice guidelines

• Judicious and supervised use of tocilizumab in compliance with the current preferred practice guidelines

• Aggressive monitoring and control of diabetes mellitus

• Strict aseptic precautions while administering oxygen (sterile water for the humidifier, daily change of the sterilized humidifier and the tubes)

• Personal and environmental hygiene

• Betadine mouth gargle (not nasal drops)

• Barrier mask covering the nose and mouth

• Consider prophylactic oral Posaconazole in high-risk patients (>3 weeks of mechanical ventilation, >3 weeks of supplemental oxygen, >3 weeks of systemic corticosteroids, uncontrolled diabetes mellitus with or without ketoacidosis, prior history of chronic sinusitis, and

co-morbidities with immunosuppression)