Table 2 Multidisciplinary team member roles in caring for CAM patients

Hospitalist, intensivist, primary care provider

1. Detect patients with early signs of mucormycosis

2. Consult specialists and services that should be part of the patient care

3. Initiate multidisciplinary team discussions

4. Serve as liaison between patient, patient caregivers, and the team

Ophthalmologist

1. Conducts eye examinations in suspicion of rhino-orbital-cerebral mucormycosis

2. Perform orbital surgical debridement when needed

Surgical specialist

1. Collect tissue for laboratory analyses

2. Perform surgical debridement when needed

Infectious disease specialist

1. Recommend appropriate diagnostic procedures

2. Assist in interpreting microbiology laboratory results

3. Review and revise therapy based on local epidemiology and susceptibility patterns

4. Select appropriate antifungal agents

5. Implement antifungal stewardship program to combat resistance

Clinical pharmacy specialist

1. Participate in multidisciplinary team discussions on antifungal drug selection

2. Recommend appropriate dose based on patient specific laboratory parameters

3. Monitor efficacy and adverse effects, therapeutic drug levels, and drug interactions

4. Recommend alternative therapies based on drug availability based on clinical practice guidelines

5. Educate patients and on antifungal therapies

6. Implement and monitor antifungal stewardship

7. Monitor drug costs by recommending formulary agents

Microbiologist

1. Promptly report critical results to the clinical care team

- Fungal elements seen on microscopy

- Immediate detection of fungal growth

- Definite fungal identification

2. Ensure external and internal validation of mucormycosis

3. Discuss differential diagnosis and suggest additional testing when needed

Pathologist

1. Immediately report positive findings to the team

2. Discuss histopathology results with the team

3. Affirm quality control of fungal stains