This protocol applies to solid organ transplant (SOT) recipients with disseminated mucormycosis who have not achieved a sufficient response to initial antifungal treatment and require escalation to a salvage approach.
Solid organ transplantation is the defining condition in this scenario. The immunosuppressed state associated with SOT places these patients at elevated risk and shapes the management path when first-line therapy falls short.
This salvage step is indicated when the initial approach — which combines surgical debridement and immediate high-dose lipid-based amphotericin B therapy — has not produced stable disease or partial response, with resolution of signs and symptoms of infection and substantial radiographical improvement assessed by weekly imaging.
The next step involves switching to a different antifungal class. Several agents within that class carry strong to moderate guideline recommendations, with further options available for progressive or extensive disease. The full selection criteria, sequencing, and any combination strategy are detailed in the complete protocol.
Stable disease or partial response, with resolution of signs and symptoms of infection and substantial radiographical improvement on imaging.