<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vestnovsu</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник Новгородского государственного университета</journal-title><trans-title-group xml:lang="en"><trans-title>Vestnik of Novgorod State University</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2076-8052</issn><publisher><publisher-name>Новгородский государственный университет имени Ярослава Мудрого</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.34680/2076-8052.2025.4(142).619-630</article-id><article-id custom-type="elpub" pub-id-type="custom">vestnovsu-426</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Фармакология, клиническая фармакология</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Pharmacology, clinical pharmacology</subject></subj-group></article-categories><title-group><article-title>Ассортимент лекарственных препаратов и особенности практического применения при мукормикозе</article-title><trans-title-group xml:lang="en"><trans-title>Assortment of medicinal preparations and features of practical use in mucormicosis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1317-7513</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Антропова</surname><given-names>Г. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Antropova</surname><given-names>G. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Антропова Галина Александровна – кандидат фармацевтических наук, доцент, заведующий кафедрой</p><p>Великий Новгород</p></bio><bio xml:lang="en"><p>Veliky Novgorod</p></bio><email xlink:type="simple">ime-farm@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7431-3777</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Оконенко</surname><given-names>Т. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Okonenko</surname><given-names>T. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Оконенко Татьяна Ивановна – доктор медицинских наук, доцент, заведующий кафедрой</p><p>Великий Новгород</p></bio><bio xml:lang="en"><p>Veliky Novgorod</p></bio><email xlink:type="simple">tat542@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Новгородский государственный университет имени Ярослава Мудрого</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Yaroslav-the-Wise Novgorod State University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>23</day><month>01</month><year>2026</year></pub-date><volume>0</volume><issue>4(142)</issue><fpage>619</fpage><lpage>630</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Антропова Г.А., Оконенко Т.И., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Антропова Г.А., Оконенко Т.И.</copyright-holder><copyright-holder xml:lang="en">Antropova G.A., Okonenko T.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://vestnovsu.elpub.ru/jour/article/view/426">https://vestnovsu.elpub.ru/jour/article/view/426</self-uri><abstract><p>В последние годы отмечается рост грибковых заболеваний, в том числе глубоких микозов. Основные факторы риска развития грибковых инфекций: химиотерапия и иммуносупрессия; декомпенсированный сахарный диабет; почечная недостаточность; септицемия у пациентов с иммуносупрессией; дегидратация, например, тяжелая диарея и рвота; алкогольный цирроз печени; онкологические заболевания; ВИЧ-инфекция. Лечение осложнений COVID-19 также привело к значительному росту резистентности у бактерий и грибов. Например, Mucorales в последнее время становятся все более устойчивыми к лекарственным средствам. Появление заболеваний, вызванных глубокими микозами, которые протекают крайне тяжело и вызывают высокую смертность, требует особого внимания к проблеме резистентности. Цель исследования – рассмотреть современное состояние арсенала лечения противогрибковых инфекций, определить факторы риска развития инвазивных микозов по литературным данным, ассортимент противогрибковых лекарственных средств, разрешенных к медицинскому применению в РФ на фармацевтическом рынке. Наиболее часто встречается риноцеребральная форма мукормикоза, с летальностью 80%. Основное лечение включает радикальное удаление некротизированных мягких и костных тканей в очаге поражения, проведение системной противогрибковой терапии липосомальным амфотерицином B (внутривенно) и симптоматической терапии. Показано, что на рынке лекарственных средств имеется малый ассортимент лекарственных форм и ограниченная номенклатура противогрибковых препаратов.</p></abstract><trans-abstract xml:lang="en"><p>In recent years, there has been an increase in the incidence of fungal infections, including deep mycoses. Key risk factors for developing fungal infections include chemotherapy and immunosuppression; decompensated diabetes mellitus; renal failure; septicemia in immunocompromised patients; dehydration, such as severe diarrhea and vomiting; alcoholic cirrhosis of the liver; cancer; and HIV infection. Treatment for complications of COVID-19 has contributed to the growth of drug resistance in bacteria and fungi. The Mucorales species are characterized by high level resistance to most currently available antifungal drugs. The emergence of severe deep mycoses with high mortality rates necessitates a focus on antifungal resistance, as fungi can become resistant to drugs designed to kill them. The objective of this study was to review the current state of treatment for antifungal infections, identify risk factors for invasive mycoses. When this was used method of the review of the literature. A list of antifungal drugs available on the Russian pharmaceutical market is provided. The most common form of mucormycosis is the rhinocerebral form, with a mortality rate reaching 80%. The main treatment includes radical removal of necrotic soft and bone tissue in the lesion, systemic antifungal therapy with liposomal amphotericin B (intravenously) and symptomatic therapy. It is shown that the pharmaceutical market has a limited range of dosage forms and a limited range of antifungal agents. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>противогрибковые лекарственные средства</kwd><kwd>азолы</kwd><kwd>перечень противогрибковых препаратов</kwd><kwd>мукормикоз</kwd><kwd>риноорбитальный мукормикоз</kwd><kwd>государственный реестр лекарственных средств</kwd><kwd>фармацевтический рынок</kwd></kwd-group><kwd-group xml:lang="en"><kwd>antifungal drugs</kwd><kwd>azoles</kwd><kwd>а list of antifungal drugs</kwd><kwd>mucormycosis</kwd><kwd>rhinoorbital mucormycosis</kwd><kwd>State Register of Medicines</kwd><kwd>pharmaceutical market</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">в Список ВОЗ приоритетных возбудителей заболеваний для НИОКР области создания новых антибиотиков: пресс-релиз. Женева, 2017. URL: https://www.who.int/ru/news-room/detail/27-02-2017-who-publishes-list-of-bacteria for-which-new-antibiotics-are-urgently-needed (Дата обращения: 13.07.2025).</mixed-citation><mixed-citation xml:lang="en">World Health Organization. WHO priority pathogens list for R&amp;D of new antibiotics: Press release. Geneva. 2017. URL: https://www.who.int/ru/news-room/detail /27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed (Accessed: 13.07.2025). (In Russian).</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Kubin C. J., McConville T. H., Donald D., Zucker J., May M., Nelson B., Istorico E., Bartram L., Small-Saunders J., Sobieszczyk M. E., Gomez-Simmonds A., Uhlemann A.-C. Characterization of bacterial and fungal infections in hospitalized patients with COVID-19 and factors associated with healthcare-associated infections // Open forum infectious diseases. 2021. 8 (6). ofab201. DOI: 10.1093/ofid/ofab201</mixed-citation><mixed-citation xml:lang="en">Kubin C. J., McConville T. H., Donald D., Zucker J., May M., Nelson B., Istorico E., Bartram, L., Small-Saunders, J., Sobieszczyk, M. E., Gomez-Simmonds, A., Uhlemann, A.-C. // Characterization of bacterial and fungal infections in hospitalized patients with COVID-19 and factors associated with healthcare-associated infections // Open Forum Infectious Diseases. 2021. 8 (6). ofab201. DOI: 10.1093/ofid/ofab201</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Аймолдина А. А., Батпенова Г. Р., Алгазина Т. О., Киян В. С., Перцух Ю. С., Амантаев Д. М. Современное состояние устойчивости дерматофитов к антимикотическим препаратам // Наука и здравоохранение. 2024. 26 (6). 173–183. DOI: 10.34689/SH.2024.26.6.020</mixed-citation><mixed-citation xml:lang="en">Aimoldina A. A., Batpenova G. R., Algazina T. O., Kiyan V. S., Pertsukh Yu. S., Amantaev D. M. The current state of dermatophyte resistance to antimycotic drugs // Science and Healthcare 2024. 26 (6). 173–183. DOI: 10.34689/SH.2024.26.6.020 (In Russian).</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Garcia-Rubio R., Monteiro M., Mellado E. Azole antifungal drugs: mode of action and resistance: reference module in life sciences. Oxford: Elsevier, 2018. 427–437. DOI: 10.1016/B978-0-12-809633-8.20731-0</mixed-citation><mixed-citation xml:lang="en">Garcia-Rubio R., Monteiro M., Mellado E. Azole antifungal drugs: mode of action and resistance: reference module in life sciences. Oxford: Elsevier, 2018. 427–437. DOI: 10.1016/B978-0-12-809633-8.20731-0</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Акимкин В. Г., Тутельян А. В., Шулакова Н. И. Микологический айсберг: современные сдвиги в эпидемиологии микозов // Инфекционные болезни. 2022. 20 (1). 120–126. DOI: 10.20953/1729-9225-2022-1-120-126</mixed-citation><mixed-citation xml:lang="en">Akimkin V. G., Tutelyan A. V., Shulakova N. I. The mycological iceberg: Recent shifts in the epidemiology of mycoses // Infectious Diseases. 2022. 20 (1). 120–126. DOI: 10.20953/1729-9225-2022-1-120-126 (In Russian).</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Хостелиди С. Н., Васильева Н. В. Обзор международных клинических рекомендаций по диагностике и лечению инвазивных микозов, ассоциированных с редкими гиалогифомицетами // Проблемы медицинской микологии. 2025. 27 (2). 15–35. DOI: 10.24412/1999-6780-2025-2-15-35</mixed-citation><mixed-citation xml:lang="en">Khostelidi S. N., Vasilieva N. V. A review of international clinical guidelines on the diagnosis and treatment of invasive mycoses associated with rare hyalohyphomycetes // Problems in Medical Mycology. 2025. 27 (2). 15–35. DOI: 10.24412/1999-6780-2025-2-15 35 (In Russian).</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Zgadzay Y., Kolosova O., Stetsenko A., Wu C., Bruchlen D., Usachev K., Validov Sh., Jenner L., Rogachev A., Yusupov M., Sachs M. S., Guskov A., Yusupov M. E-site drug specificity of the human pathogen Candida albicans ribosome // Science advances. 2022. 8 (21). DOI: 10.1126/sciadv.abn1062</mixed-citation><mixed-citation xml:lang="en">Zgadzay Y., Kolosova O., Stetsenko A., Wu C., Bruchlen D., Usachev K., Validov Sh., Jenner L., Rogachev A., Yusupov M., Sachs M. S., Guskov A., Yusupov M. E-site drug specificity of the human pathogen Candida albicans ribosome // Science Advances. 2022. 8 (21). DOI: 10.1126/sciadv.abn1062</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Stepanov A. A., Vasilchenko A. V., Vasilchenko А. S. Subinhibitory effects of 2,4-diacetylphloroglucinol on filamentous fungus Aspergillus fumigatus // Journal of applied microbiology. 2013. 134 (12). DOI: 10.1093/jambio/lxad294</mixed-citation><mixed-citation xml:lang="en">Stepanov A. A., Vasilchenko A. V., Vasilchenko А. S. Subinhibitory effects of 2,4-diacetylphloroglucinol on filamentous fungus Aspergillus fumigatus // Journal of Applied Microbiology. 2013. 134 (12). DOI: 10.1093/jambio/lxad294</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Kuvarina A. E., Gavryushina I. A., Sykonnikov M. A., Efimenko T. A., Markelova N. N., Bilanenko E. N., Bondarenko S. A., Kokaeva L. Y., Timofeeva A. V., Serebryakova M. V., Barashkova A. S., Rogozhin E. A., Georgieva M. L., Sadykova V. S. Exploring peptaibol’s profile, antifungal, and antitumor activity of Emericellipsin A of Emericellopsis species from soda and saline soils // Molecules. 2022. 27 (5). 1726. DOI: 10.3390/molecules27051736</mixed-citation><mixed-citation xml:lang="en">Kuvarina A. E., Gavryushina I. A., Sykonnikov M. A., Efimenko T. A., Markelova N. N., Bilanenko E. N., Bondarenko S. A., Kokaeva L. Y., Timofeeva A. V., Serebryakova M. V., Barashkova A. S., Rogozhin E. A., Georgieva M. L., Sadykova V. S. Exploring peptaibol’s profile, antifungal, and antitumor activity of Emericellipsin A of Emericellopsis species from soda and saline soils // Molecules. 2022. 27 (5). 1726. DOI: 10.3390/molecules27051736</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Proshina L. G., Okonenko T. I., Antropova G. A., Zheznyakovskaya L. F., Proshin A. V. Development of ointment with antimicrobial activity from plant materials and its study // IOP Conference Series: Earth and Environmental Science. 2020. 613. 012116. DOI: 10.1088/1755-1315/613/1/012116</mixed-citation><mixed-citation xml:lang="en">Proshina L. G., Okonenko T. I., Antropova G. A., Zheznyakovskaya L. F., Proshin A. V. Development of ointment with antimicrobial activity from plant materials and its study // IOP Conference Series: Earth and Environmental Science, Vol. 613: The International Scientific and Practical Conference Biotechnology in the Agro-Industrial Complex and Sustainable Environmental Management, 22 October 2020, Veliky Novgorod, Russian Federation. Veliky Novgorod, 2020. DOI: 10.1088/1755-1315/613/1/012116</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Antifungal agents in clinical and preclinical development: overview and analysis. 2025: World Health Organization. URL: https://www.who.int/publications/i/item/9789240105140 (Дата обращения: 13.07.2025).</mixed-citation><mixed-citation xml:lang="en">Antifungal agents in clinical and preclinical development: overview and analysis. 2025: World Health Organization. URL: https://www.who.int/ publications/i/item/9789240105140 (Accessed: 13.07.2025).</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">WHO fungal priority pathogens list to guide research, development and public health action 2022: World Health Organization. URL: https://www.who.int/publications/i/item/9789240060241 (Дата обращения: 13.07.2025).</mixed-citation><mixed-citation xml:lang="en">WHO fungal priority pathogens list to guide research, development and public health action 2022: World Health Organization. URL: https://www.who.int/publications /i/item/9789240060241 (Accessed: 13.07.2025).</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Prakash H., Chakrabarti A. Epidemiology of Mucormycosis in India // Microorganisms. 2021. 9 (3). 523. DOI: 10.3390/microorganisms9030523</mixed-citation><mixed-citation xml:lang="en">Prakash H., Chakrabarti A. Epidemiology of Mucormycosis in India // Microorganisms. 2021. 9 (3). 523. DOI: 10.3390/microorganisms9030523</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Seidel D., Simon M., Sprute R., Lubnow M., Evert K., Speer C., Seeßle J., Khatamzas E., Merle U., Behrens C., Blau I. W., Enghard P., Haas C. S., Steinmann J., Kurzai O., Cornely O. A. Results from a national survey on COVID-19-associated mucormycosis in Germany: 13 patients from six tertiary hospitals // Mycoses. 2022. 65 (1). 103–109. DOI: 10.1111/myc.13379</mixed-citation><mixed-citation xml:lang="en">Seidel D., Simon M., Sprute R., Lubnow M., Evert K., Speer C., Seeßle J., Khatamzas E., Merle U., Behrens C., Blau I. W., Enghard P., Haas C. S., Steinmann J., Kurzai O., Cornely O. A. Results from a national survey on COVID-19-associated mucormycosis in Germany: 13 patients from six tertiary hospitals // Mycoses. 2022. 65 (1). 103–109. DOI: 10.1111/myc.13379</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Попова М. О., Рогачева Ю. А. Мукормикоз: современные возможности диагностики и лечения, существующие проблемы и новые тенденции в терапии // Клиническая микробиология и антимикробная химиотерапия. 2021. 23 (3). 226–238. DOI: 10.36488/cmac.2021.3.226238</mixed-citation><mixed-citation xml:lang="en">Popova M. O., Rogacheva Yu. A. Mucormycosis: modern diagnostics and treatment, existing problems and new trends in antifungal therapy // Clinical Microbiology and Antimicrobial Chemotherapy 2021. 23 (3). 226–238. DOI: 10.36488/cmac.2021.3.226238 (In Russian).</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Абдуллозода Дж. А., Ходжамурадов Г. М., Шамсзода Х. А., Хамидов М. Г., Турсунов Р. А. Организация комплексного лечения риноцеребральной формы мукормикоза в постковидном периоде // Здравоохранение Таджикистана. 2023. 357 (2). 5–11. DOI: 10.52888/0514-2515-2023-357-2-5-11</mixed-citation><mixed-citation xml:lang="en">Abdullozoda J. A., Khodzhamuradov G. M., Shamszoda Kh. A., Khamidov M. G., Tursunov R. A. Organization of comprehensive treatment of the rhinocerebral form of mucormycosis in the post-COVID period // Healthcare of Tajikistan. 2023. 357 (2). 5–11. DOI: 10.52888/0514-2515-2023-357-2-5-11 (In Russian).</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Государственный реестр лекарственных средств. URL: http://grls.rosminzdrav.ru/grls.aspx (Дата обращения: 15.07.2025).</mixed-citation><mixed-citation xml:lang="en">State register of medicinal products. Retrieved http://grls.rosminzdrav.ru/grls.aspx (Accessed: 15.07.2025). (In Russian).</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Инфекционные болезни: национальное руководство. Москва: ГЭОТАР Медиа. 2019. 1104 с.</mixed-citation><mixed-citation xml:lang="en">from Infectious diseases: National guideline. Moscow: GEOTAR-Media, 2019. 1104 p. (In Russian).</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
