New Perspectives on Antimicrobial Agents: Tecovirimat for Treatment of Human Monkeypox Virus

Antimicrob Agents Chemother. 2022 Dec 20;66(12):e0122622. doi: 10.1128/aac.01226-22. Epub 2022 Nov 14.


Tecovirimat is an antiviral drug initially developed against variola virus (VARV) to treat smallpox infection. Due to its mechanism of action, it has activity against the family of orthopoxviruses, including vaccinia and the human monkeypox virus (HMPXV). Efficacy studies have thus far been limited to animal models, with human safety trials showing no serious adverse events. Currently approved by the FDA only for the treatment of smallpox, tecovirimat shows promise for the treatment of HMPXV. Tecovirimat has been prescribed via an expanded access for an investigational new drug protocol during the 2022 outbreak. This review will examine the literature surrounding tecovirimat's mechanism of action, pharmacokinetics, safety, efficacy, and potential for resistance.

Keywords: TPOXX; human monkeypox virus; tecovirimat.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Antiviral Agents / adverse effects
  • Benzamides / pharmacology
  • Benzamides / therapeutic use
  • Humans
  • Isoindoles / pharmacology
  • Isoindoles / therapeutic use
  • Monkeypox virus
  • Monkeypox* / drug therapy
  • Smallpox* / drug therapy
  • Variola virus*


  • Antiviral Agents
  • Benzamides
  • Isoindoles