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Table 2 Alternative antifungal agents given after treatment failure with Voriconazole or LAmB

From: Pharmacoeconomic evaluation of voriconazole vs. liposomal amphotericin B in empiric treatment of invasive fungal infections in Turkey

Reason for treatment failure Alternative given
Voriconazole arm LAmB arm
Infusion-related reactionsa Caspofunginb Voriconazolec
Nephrotoxicity Caspofunginb Caspofunginb
Hepatotoxicity LAmBd Caspofunginb
Suspected fungal infection LAmBe Voriconazolec
Persistent fever LAmBe Voriconazolec
Breakthrough fungal infection
Aspergillus spp. LAmBd Voriconazolec
Candida spp. Caspofunginb Caspofunginb
Zygomycetes spp. LAmBe N/A
DematiaceousMoulds N/A LAmB plus posaconazolef
Moulds not identified N/A LAmBe
Non-responding baseline fungal infection
Aspergillus spp. LAmBd Voriconazolec
Candida spp. Caspofunginb Caspofunginb
Zygomycetes spp. LAmB plus posaconazolef N/A
Trichoderma fungemia N/A Voriconazolec
Fusarium spp. N/A LAmB plus posaconazolef
Moulds not identified N/A LAmB plus posaconazolef
  1. aA switch to alternative therapy due to infusion-related reactions included commencement of pre-dose diphenhydramine; bCaspofungin dose 70 mg on day one, 50 mg thereafter; cVoriconazole dose 6 mg/kg i.v. twice daily on day one, 4 mg/kg i.v. twice daily or 400 mg p.o. twice daily thereafter (22% in base case received oral voriconazole); dLAmB dose 3 mg/kg/day; eLAmB 5 mg/kg/day; fLAmB dose 5 mg/kg/day, posaconazole 200 mg four times per day.