Treatment of Non-Aspergillus Mold Infections: a Focus on Mucormycosis and Fusariosis

Mucormycosis and fusariosis are associated with severe morbidity and high fatality rate. This review will discuss the challenges associated with the treatment of mucormycosis and fusariosis with a focus on recent data on antifungal susceptibility, novel therapeutic modalities, and combination therapy. Overall, the review aims to provide guidance to optimize management of these difficult-to-treat infections. Isavuconazole has comparable efficacy with liposomal amphotericin B for the treatment of mucormycosis. Treatment of fusariosis remains challenging, but voriconazole has been associated with improved outcome. Posaconazole has successfully been used as salvage therapy for both infections. Combination therapy is increasingly used although robust data supporting its efficacy is limited. The first-line therapy for mucormycosis remains liposomal amphotericin B with posaconazole and isavuconazole being acceptable alternatives. Fusariosis should be treated with either voriconazole or liposomal amphotericin B. Combination therapy may have a role although its clinical benefit remains uncertain.