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Aspergillosis

Invasive pulmonary aspergillosis

  • Preferred regimen: Voriconazole (6 mg/kg IV every 12 h for 1 day, followed by 4 mg/kg IV every 12 h; oral dosage is 200 mg every 12 h)
  • Alternative regimen: Liposomal amphotericin B(L-AMB) 3–5 mg/kg/day IV OR Amphotericin B lipid complex (ABLC) 5 mg/ kg/day IV OR Caspofungin (70 mg day 1 IV and 50 mg/day IV thereafter) OR Micafungin (IV 100–150 mg/day; dose not established ), Posaconazole (200 mg QID initially, then 400 mg BID PO after stabilization of disease )OR Itraconazole (dosage depends upon formulation)

Invasive sinus aspergillosis

  • Preferred regimen: Voriconazole (6 mg/kg IV every 12 h for 1 day, followed by 4 mg/kg IV every 12 h; oral dosage is 200 mg every 12 h)
  • Alternative regimen: Liposomal amphotericin B(L-AMB) 3–5 mg/kg/day IV OR Amphotericin B lipid complex (ABLC) 5 mg/ kg/day IV OR Caspofungin (70 mg day 1 IV and 50 mg/day IV thereafter) OR Micafungin (IV 100–150 mg/day; dose not established ), Posaconazole (200 mg QID initially, then 400 mg BID PO after stabilization of disease )OR Itraconazole (dosage depends upon formulation)

Tracheobronchial aspergillosis

  • Preferred regimen: Voriconazole (6 mg/kg IV every 12 h for 1 day, followed by 4 mg/kg IV every 12 h; oral dosage is 200 mg every 12 h)
  • Alternative regimen: Liposomal amphotericin B(L-AMB) 3–5 mg/kg/day IV OR Amphotericin B lipid complex (ABLC) 5 mg/ kg/day IV OR Caspofungin (70 mg day 1 IV and 50 mg/day IV thereafter) OR Micafungin (IV 100–150 mg/day; dose not established ), Posaconazole (200 mg QID initially, then 400 mg BID PO after stabilization of disease )OR Itraconazole (dosage depends upon formulation)

Chronic necrotizing pulmonary aspergillosis

  • Preferred regimen: Voriconazole (6 mg/kg IV every 12 h for 1 day, followed by 4 mg/kg IV every 12 h; oral dosage is 200 mg every 12 h)
  • Alternative regimen: Liposomal amphotericin B(L-AMB) 3–5 mg/kg/day IV OR Amphotericin B lipid complex (ABLC) 5 mg/ kg/day IV OR Caspofungin (70 mg day 1 IV and 50 mg/day IV thereafter) OR Micafungin (IV 100–150 mg/day; dose not established ), Posaconazole (200 mg QID initially, then 400 mg BID PO after stabilization of disease )OR Itraconazole (dosage depends upon formulation)

Aspergillosis of the CNS

  • Preferred regimen: Voriconazole (6 mg/kg IV every 12 h for 1 day, followed by 4 mg/kg IV every 12 h; oral dosage is 200 mg every 12 h)
  • Alternative regimen: Liposomal amphotericin B(L-AMB) 3–5 mg/kg/day IV OR Amphotericin B lipid complex (ABLC) 5 mg/ kg/day IV OR Caspofungin (70 mg day 1 IV and 50 mg/day IV thereafter) OR Micafungin (IV 100–150 mg/day; dose not established ), Posaconazole (200 mg QID initially, then 400 mg BID PO after stabilization of disease )OR Itraconazole (dosage depends upon formulation)

Aspergillus infections of the heart (endocarditis, pericarditis, and myocarditis)

Aspergillus osteomyelitis and septic arthritis

Aspergillus infections of the eye (endophthalmitis and keratitis)

Cutaneous aspergillosis