球孢子菌病抗真菌药物研究进展

doi:10.19803/j.1672-8629.20250787

摘要/Abstract

摘要： 目的综述球孢子菌病（Coccidioidomycosis）抗真菌药物的临床应用现状与新型药物研究进展，为药物研发及临床合理用药提供参考。方法通过检索中国知网、万方数据、PubMed、Elsevier等数据库，归纳常用球孢子菌病抗真菌药物的药理学特征、临床疗效及不良反应谱，并对新型药物的作用机理和临床试验数据进行综述。结果氟康唑（Fluconazole）与伊曲康唑（Itraconazole）为当前临床一线药物，但两者多需长期应用，应警惕其神经系统、胃肠道、肝肾功能损害等不良反应;两性霉素B（Amphotericin B, AmB）虽具有良好的抗真菌活性，但其肾毒性显著，仅用于重症或挽救性治疗。奥洛罗芬（Olorofim）等新型抗真菌药物尚处于临床验证阶段，不良反应涉及多系统，但总体发生率与严重程度较低。结论目前尚无针对球孢子菌的特异性药物。未来研究应聚焦于开发毒性更低、靶向性更强的新型抗真菌药物，为治疗提供更多安全高效的选择。

关键词: 球孢子菌, 球孢子菌病, 抗真菌药物, 药品不良反应

Abstract: Objective To summarizes the current efficacy of and recent advances in antifungal agents for coccidioidomycosis so as to provide data for drug development and guidance for clinical practice. Methods Literature was retrieved from such databases as CNKI, Wanfang Data, PubMed, and Elsevier. The pharmacological profiles, clinical efficacy, and adverse reaction spectra of commonly used antifungal drugs were summarized. Additionally, the mechanisms of action and clinical trial data of novel antifungal agents were outlined. Results Fluconazole and itraconazole were currently first-line clinical treatments. However, both required prolonged administration, hence a need for vigilance on potential neurological, gastrointestinal, hepatic, and renal toxicities. Amphotericin B had potent antifungal activity but significant nephrotoxicity, limiting its use to critically ill patients or salvage treatment. Novel antifungal agents, such as olorofim, were still undergoing clinical validation. While their adverse effects involved multiple organ systems, the overall incidence was relatively low and symptoms were not severe. Conclusion No specific antifungal agent targeting Coccidioides infection is currently available. Future research should prioritize the development of new antifungal agents with lower toxicity and greater target specificity to provide safer and more effective therapeutic options.

Key words: Coccidioides, Coccidioidomycosis, Antifungal Agent, Adverse Drug Reactions

中图分类号:

R978.5

丁姝文, 马瑞泽, 陈志海. 球孢子菌病抗真菌药物研究进展[J]. 中国药物警戒, 2026, 23(2): 224-228.

DING Shuwen, MA Ruize, CHEN Zhihai. Research Advances in Antifungal Agents for Coccidioidomycosis[J]. Chinese Journal of Pharmacovigilance, 2026, 23(2): 224-228.

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