| Drug | Class | Adult | Paediatric | Notes |
|---|---|---|---|---|
| Voriconazole[1] | Triazole antifungal | Loading 6 mg/kg IV q12h × 2 doses, then 4 mg/kg IV q12h or 200 mg PO BD; therapeutic drug monitoring (target trough 1–5.5 mg/L) | 9 mg/kg IV q12h loading then 8 mg/kg q12h | Primary therapy for invasive aspergillosis (pulmonary, sinus, CNS); monitor LFTs and visual side effects |
| Isavuconazole[1] | Triazole antifungal | Loading 200 mg PO/IV q8h × 6 doses, then 200 mg once daily | — | Alternative first-line; non-inferior to voriconazole, fewer drug interactions, no QTc prolongation, easier administration |
| Liposomal amphotericin B[1] | Polyene antifungal | 3–5 mg/kg IV once daily | 3–5 mg/kg IV once daily | Salvage or primary when triazoles contraindicated (drug interaction, refractory disease) |
| Caspofungin or anidulafungin[1] | Echinocandin | Caspofungin 70 mg loading then 50 mg IV daily | — | Salvage therapy or in combination for refractory disease; not for primary monotherapy |
| Posaconazole[1] | Triazole (prophylaxis) | 300 mg PO BD × 1 day, then 300 mg daily (delayed-release tablet) | — | Prophylaxis in high-risk neutropenic patients (AML induction, GVHD) |
| Prednisolone (oral) for ABPA[2] | Glucocorticoid | 0.5 mg/kg/day for 2 weeks then taper over 8–12 weeks | — | ABPA acute exacerbation; itraconazole 200 mg BD as steroid-sparing add-on |
Diagnosis and treatment of invasive aspergillosis (pulmonary, sinus, CNS, disseminated) and chronic forms; isavuconazole and voriconazole as first-line.