Rhino-orbital-cerebral mucormycosis requires a coordinated first-line protocol. The structured approach below addresses both the surgical and systemic antifungal components, with treatment response assessed on an ongoing basis.

Treatment approach (partial overview)

First-line management combines early, complete surgical debridement — repeated as required — with immediate systemic antifungal therapy started at full dose from day one. Once stable disease is achieved, the protocol specifies criteria for continuing or transitioning to an oral regimen.

Full drug selection, dosing strategy, sequencing, and step-down criteria are detailed in the complete structured protocol.

Treatment goal

Stable disease or partial response of mucormycosis on response assessment (e.g., weekly imaging).

References

The guideline group strongly supports an early complete surgical treatment for mucormycosis whenever possible, in addition to systemic antifungal treatment.
Resection or debridement should be repeated as required.
First-line treatment with liposomal amphotericin B 5–10 mg/kg per day is strongly supported across all patterns of organ involvement.
Doses should not be slowly increased over several days; rather, the full daily dose should be given from the first treatment day.
There is moderate support for intravenous treatment until stable disease is achieved.
When switching to oral treatment, use of isavuconazole or posaconazole delayed release tablets is strongly supported.

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What Is the First-Line Treatment of Rhino-Orbital-Cerebral Mucormycosis?

References