Novel Drug Delivery Systems for Vulvovaginal Candidiasis: A Systematic Review

Abstract

Vulvovaginal candidiasis (VVC) is a prevalent fungal infection affecting approximately 75% of women at least once during their lifetime. Conventional antifungal therapies are hampered by poor drug bioavailability, rapid vaginal clearance, and emerging resistance. Novel drug delivery systems (NDDS) offer promising alternatives by enhancing drug retention, permeation, and therapeutic efficacy.

Objective: This systematic review critically evaluates current NDDS including liposomes, niosomes, solid lipid nanoparticles (SLN), nano emulsions, polymeric nanoparticles, in situ gels, microemulsions, vaginal films, cyclodextrin complexes, and dendrimers developed for the treatment of VVC.

Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar (2010–2024) using MeSH terms including 'vulvovaginal candidiasis', 'novel drug delivery', 'vaginal nanoparticles', and 'antifungal formulation'. Patent databases including USPTO, EPO, and WIPO were also searched.

Results: A total of 27 primary research articles and 10 relevant patents were reviewed. Nanoparticle-based formulations demonstrated superior antifungal activity with significant improvements in MIC values (2–8-fold reduction), prolonged drug release (24–72 h), and enhanced vaginal retention compared to conventional formulations. In situ gelling systems and mucoadhesive platforms showed the greatest promise for patient compliance and sustained therapeutic effect.

Conclusion: NDDS represent a significant advancement in the management of VVC, offering improved drug bioavailability, reduced dosing frequency, and potential to overcome antifungal resistance. Further clinical translation and regulatory studies are required.