Which antifungal is active against mucorales?

• A. Fluconazole
• B. Liposomal amphotericin B
• C. Voriconazole
• D. Itraconazole

Answer: (B)

Mucormycosis is caused by Mucorales, fungi that invade blood vessels and cause rapid, invasive disease. The antifungal with reliable activity against these organisms is amphotericin B, and the liposomal formulation is preferred because it allows higher dosing with less kidney toxicity, which is crucial for treating extensive invasion. Among common antifungals, fluconazole, voriconazole, and itraconazole have poor activity against Mucorales, so they’re not effective choices for this infection. Liposomal amphotericin B remains the best option for mucormycosis, often used with surgical debridement for best outcomes.