MYC 4.1 Mucormycosis/Zygomycosis

Recommendations

≥ 18 years
	Dosage	Remarks
1st choice	amphotericin B liposomal (Ambisome) IV 5 mg/kg once daily	Surgical debridement where possible. Treatment duration 6 weeks–6 months guided by resolution of the infection. If susceptibility demonstrated, consider step-down to posaconazole or isavuconazole tablets with therapeutic drug monitoring (TDM)
2nd choice	posaconazole IV 300 mg once daily	In case of failure of, or intolerance to, amphotericin B (not for cerebral involvement)
2nd choice	isavuconazole IV loading dose 200 mg, 3 times daily for 2 days followed by isavuconazole IV 200 mg once daily	In case of failure of, or intolerance to, amphotericin B (also for cerebral involvement)