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