. 2022 Feb 26;67(3):363–387. doi: 10.1007/s12223-021-00934-5

Table 6.

Patient groups, intervention and their salvage treatment during mucormycosis (Vujanovic et al. 2017)

Treatment	Patient group	Intervention
Fever driven or Empirical	• unresponsive to antibiotics, Febrile neutropenia, imaging–reverse halo, galactomannan negative; other atypical presentation or multiple nodules	Liposomal amphotericin B
Prophylaxis	• graft versus host disease or Prolonged neutropenia • SOT adult, Prolonged neutropenia, heart, and lung • Immunocompromised due to a previous mucormycosis diagnosis	Posaconazole DR intravenous or tablet 2 × 300 mg day 1, 1 × 300 mg from day 2 Isavuconazole intravenous or per oral 3 × 200 mg days 1–2, 1 × 200 mg/day from day 3, or 1 × 200 mg/day from day 1 In the same patient, surgical resection and the last medicine effective as a secondary prophylactic, switch from amphotericin B to posaconazole after 3–6 weeks if practicable
Salvage	• Refractory disease • Toxicity to primary therapy	Isavuconazole intravenous or per oral 3 × 200 mg days 1–2, 1 × 200 mg from day 3 Posaconazole DR tablet or intravenous 2 × 300 mg day 1, 1 × 300 mg from day 2 Amphotericin B, lipid formulations, 5–10 mg/kg (lower dose in patients with renal toxicity)

Treatment

Patient group

Intervention

Fever driven or Empirical

• unresponsive to antibiotics, Febrile neutropenia, imaging–reverse halo, galactomannan negative; other atypical presentation or multiple nodules

Liposomal amphotericin B

Prophylaxis

• graft versus host disease or Prolonged neutropenia

• SOT adult, Prolonged neutropenia, heart, and lung

• Immunocompromised due to a previous mucormycosis diagnosis

Posaconazole DR intravenous or tablet 2 × 300 mg day 1, 1 × 300 mg from day 2

Isavuconazole intravenous or per oral 3 × 200 mg days 1–2, 1 × 200 mg/day from day 3, or 1 × 200 mg/day from day 1

In the same patient, surgical resection and the last medicine effective as a secondary prophylactic, switch from amphotericin B to posaconazole after 3–6 weeks if practicable

Salvage

• Refractory disease

• Toxicity to primary therapy

Isavuconazole intravenous or per oral 3 × 200 mg days 1–2, 1 × 200 mg from day 3

Posaconazole DR tablet or intravenous 2 × 300 mg day 1, 1 × 300 mg from day 2 Amphotericin B, lipid formulations, 5–10 mg/kg (lower dose in patients with renal toxicity)