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Mould

- Significant mortality. Consult Infectious Diseases and/or pharmacist.

- Catheter removal strongly recommended.

Aspergillus spp

Empiric Therapy	Intermittent Dosing 1 exchange daily with dwell time at least 6h	Continuous Dosing (per each L bag)	Duration
Voriconazole PO	200mg PO bid	200mg PO bid	See Duration
or
Voriconazole IP	2.5mg/kg once per day	No data	See Duration
Alternative
Posaconazole PO	300mg PO bid x 2 doses LD, then 300mg PO daily	300mg PO bid x 2 doses LD, then 300mg PO daily	See Duration
or
Isavuconazole PO/IV	200mg PO/IV q8h x 6 doses LD, then 200mg PO/IV daily	200mg PO/IV q8h x 6 doses LD, then 200mg PO/IV daily	See Duration
or
Amphotericin B, desoxycholate IV	0.75-1mg/kg IV over 4-6h daily	0.75-1mg/kg IV over 4-6h daily	See Duration
or
Amphotericin B, liposomal IV	3-5mg/kg IV daily	3-5mg/kg IV daily	See Duration

Mucormycetes

Empiric Therapy	Dose	Duration
Amphotericin B, desoxycholate IV	0.75-1mg/kg IV over 4-6h daily	See Duration
or
Amphotericin B, liposomal IV	3-5mg/kg IV daily	See Duration
or
Posaconazole PO	300mg PO bid x 2 doses LD, then 300mg PO daily	See Duration

IP = intraperitoneally

LD = loading dose