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Advanced Solid Formulations For Vulvovaginal Candidiasis

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Abstract

Vulvovaginal candidiasis (VVC) is an opportunistic and endogenous infection caused by a fungus of the Candida genus, which can cause pruritus, dysuria, vulvar edema, fissures and maceration of the vulva. The treatment of vaginal candidiasis is carried out mainly by antifungal agents of azole and polyene classes; however, fungal resistance cases have been often observed. For this reason, new therapeutic agents such as essential oils, probiotics and antimicrobial peptides are being investigated, which can be combined with conventional drugs. Local administration of antimicrobials has also been considered to allow greater control of drug delivery and reduce or avoid undesirable systemic adverse effects. Conventional dosage forms such as creams and ointments result in reduced residence time in the mucosa and non-sustained and variable drug delivery. Therefore, advanced solid formulations such as intravaginal rings, vaginal films, sponges and nanofibers have been purposed. In these systems, polymers in different ratios are combined aiming to achieve a specific drug release profile and high mucoadhesion. Overall, a more porous matrix structure leads to a higher rate of drug release and mucoadhesion. The advantages, limitations and technological aspects of each dosage form are discussed in detail in this review.

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Data Availability

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

Abbreviations

AMPs:

Antimicrobial peptides

BN:

Butoconazole nitrate

BZY:

Benzydamine

CA:

Chitosan ascorbate

CB:

Carbopol 971NF

CFU:

Colony forming units

CH:

Chitosan

CTZ:

Clotrimazole

EB:

Elongation at break

ECN:

Econazole nitrate

EPS:

Extracellular polymeric substances

FD4:

Fluoresceine isothiocyanate dextran

FLZ:

Fluconazole

HAS:

Sodium hyaluronate/lysine acetate

HPC:

Hydroxypropyl cellulose

HPMC:

Hydroxypropyl methylcellulose

IPM:

Isopropyl myristate

IVRs:

Intravaginal rings

KLV:

Killing log values

MFC:

Minimum fungicidal concentration

MIC:

Minimum inhibitory concentration

NP:

Nanoparticle

PEG:

Polyethylene glycol

PG:

Propylene glycol

PLGA:

Poly(lactic-co-glycolic acid)

PN:

Polymeric nanofibers

PVA:

Polyvinyl alcohol

PVP:

Polyvinylpyrrolidone

RVVC:

Recurrent vulvovaginal candidiasis

SAP:

Secreted aspartyl proteinase

SD:

Solid dispersions

SEM:

Scanning electron microscopy

SVF:

Simulated vaginal fluid

TCZ:

Tioconazole

TPP:

Tripolyphosphate

TPU:

Thermoplastic polyurethane

TS:

Tensile strength

TTO:

Tea tree oil

VVC:

Vulvovaginal candidiasis

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Acknowledgements

Julia Conte thank the Brazilian governmental agency CAPES/MEC for her scholarship. The authors thank Gilberto Pereira (gpdobrasil@gmail.com) for his generous support with the preparation of the figures.

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Authors and Affiliations

  1. Postgraduate Program in Pharmacy (PGFAR), Federal University of Santa Catarina, Trindade, Florianopolis, SC, 88040-900, Brazil

    Júlia Conte & Thiago Caon

  2. Polymeric Materials Research Group, Chemistry Department, Federal University of Santa Catarina, Trindade, Florianopolis, SC, 88040-900, Brazil

    Alexandre Luis Parize

Authors
  1. Júlia Conte
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  2. Alexandre Luis Parize
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  3. Thiago Caon
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Contributions

Julia Conte: Conceptualization; Writing—Original Draft.

Alexandre Luis Parize: Review & Editing.

Thiago Caon: Conceptualization; Writing—Review & Editing; Supervision.

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Correspondence to Thiago Caon.

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Conte, J., Parize, A.L. & Caon, T. Advanced Solid Formulations For Vulvovaginal Candidiasis. Pharm Res 40, 593–610 (2023). https://doi.org/10.1007/s11095-022-03441-5

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  • DOI: https://doi.org/10.1007/s11095-022-03441-5

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