Question:
Which of the following antifungal agents is NOT effective for the treatment of mucormycosis?
Which of the following antifungal agents is NOT effective for the treatment of mucormycosis?
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The azole used against Aspergillus that actually predisposes to breakthrough Mucorales infection.
Updated On: Jun 25, 2026
- Isavuconazole
- Posaconazole
- Voriconazole
- Amphotericin B
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The Correct Option is C
Solution and Explanation
Step 1: Recall first-line therapy for mucormycosis.
Mucormycosis (caused by Mucorales - Rhizopus, Mucor, etc.) is treated primarily with liposomal amphotericin B plus aggressive surgical debridement and control of the predisposing condition (e.g. diabetic ketoacidosis).
Step 2: Salvage / step-down azoles.
Among the azoles, only posaconazole and isavuconazole have reliable activity against Mucorales and are used as step-down or salvage therapy.
Step 3: Identify the ineffective drug.
Voriconazole has NO activity against Mucorales. In fact, voriconazole prophylaxis (used against Aspergillus) is a recognised risk factor for breakthrough mucormycosis. Hence it is the drug that should not be given.
Step 4: Why the other options are wrong (they ARE effective).
• Amphotericin B - drug of choice.
• Posaconazole - effective, used for step-down/salvage.
• Isavuconazole - effective, FDA-approved for mucormycosis.
Key fact: Voriconazole does not cover Mucorales and is ineffective in mucormycosis.
Mucormycosis (caused by Mucorales - Rhizopus, Mucor, etc.) is treated primarily with liposomal amphotericin B plus aggressive surgical debridement and control of the predisposing condition (e.g. diabetic ketoacidosis).
Step 2: Salvage / step-down azoles.
Among the azoles, only posaconazole and isavuconazole have reliable activity against Mucorales and are used as step-down or salvage therapy.
Step 3: Identify the ineffective drug.
Voriconazole has NO activity against Mucorales. In fact, voriconazole prophylaxis (used against Aspergillus) is a recognised risk factor for breakthrough mucormycosis. Hence it is the drug that should not be given.
Step 4: Why the other options are wrong (they ARE effective).
• Amphotericin B - drug of choice.
• Posaconazole - effective, used for step-down/salvage.
• Isavuconazole - effective, FDA-approved for mucormycosis.
Key fact: Voriconazole does not cover Mucorales and is ineffective in mucormycosis.
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