Recent Advances in Vaginal Delivery for the Treatment of Vulvovaginal Candidiasis

Background: Vulvovaginal candidiasis (VVC) is a common vaginal infection caused by candida species, affecting 70% of the women. It may occur due to the imbalance in the vaginal micro- biodata, pregnancy, diabetes, use of antibiotics, frequent sexual activities or AIDS. Aim: The main aim of this review is to provide overview about different vaginal delivery systems for the administration of antifungal agents like conventional, mucoadhesive and muco-penetrating delivery systems. Method: The conventional delivery systems available have limited efficacy due to the less residence time and adverse effects. In order to overcome these issues, a delivery system with mucoadhesive and muco-penetrating properties is required. Mucoadhesive polymers have excellent binding properties with mucin and thus increasing residence time. On the other hand, muco-penetrating polymers transport the antifungal agents across the mucus layer. Results: This review summarizes the pathophysiology of VVC along with novel delivery systems for the treatment of infection through mucoadhesive and muco-penetrating approaches. Surface modifications of nano/ microparticles with mucoadhesive or muco-penetrating particles may provide delivery systems with improved therapeutic efficacy. Conclusion: Based on the available data, conventional and mucoadhesive drug delivery systems have some limitations, they still require improvement/ development for safe and effective delivery of antifungal agents.