title: New strategies for local treatment of vaginal infections.
abstract: Vaginal infections are extremely prevalent, particularly among women of reproductive age. Although they do not result in high mortality rates, these infections are associated with high levels of anxiety and reduction of quality of life. In most cases, topical treatment of vaginal infections has been shown to be at least as effective as oral treatment, resulting in higher local drug concentrations, with fewer drug interactions and adverse effects. Furthermore, the emergence of microbial resistance to chemotherapeutics and the difficulties in managing infection recurrences sustain the need for more effective local treatments. However, conventional dosage forms have been associated with low retention in the vagina and discomfort. Formulation strategies such as the development of bioadhesive, thermogelling systems and microtechnological or nanotechnological approaches have been proposed to improve delivery of traditional drugs, and other treatment modalities such as new drugs, plant extracts, and probiotics are being studied. This article reviews the recent strategies studied to improve the treatment and prevention of the commonest vaginal infections-namely, vaginal bacteriosis, aerobic vaginitis, vulvovaginal candidosis, and trichomoniasis-through the intravaginal route.
authors.affiliation: CICS-UBI: Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal; Pharmacy Department, Centro Hospitalar Cova da Beira, Quinta do Alvito, 6200-251 Covilhã, Portugal; Labfit-Health Products Research and Development (HPRD), Lda, Faculty of Health Sciences, University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal. Electronic address: rpo@fcsaude.ubi.pt.
authors.forename: Rita
authors.initials: R
authors.lastname: Palmeira-de-Oliveira
authors.affiliation: CICS-UBI: Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal; Pharmacy Department, Centro Hospitalar Cova da Beira, Quinta do Alvito, 6200-251 Covilhã, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Palmeira-de-Oliveira
authors.affiliation: CICS-UBI: Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal; Child and Woman's Health Department, Centro Hospitalar Cova da Beira Quinta do Alvito, 6200-251 Covilhã, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Martinez-de-Oliveira
mesh_terms: D000282:Administration, Intravaginal; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy; D016503:Drug Delivery Systems / Q000379:methods*; D005260:Female; D006801:Humans; D009822:Oils, Volatile / Q000627:therapeutic use; D019936:Probiotics / Q000627:therapeutic use; D013678:Technology, Pharmaceutical / Q000379:methods*; D014247:Trichomonas Vaginitis / Q000188:drug therapy; D014621:Vagina / Q000502:physiology; D066228:Vaginal Absorption; D014622:Vaginal Creams, Foams, and Jellies / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D014627:Vaginitis / Q000188:drug therapy*; D016585:Vaginosis, Bacterial / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D009822:Oils, Volatile; D014622:Vaginal Creams, Foams, and Jellies
keywords: Bacterial vaginosis; Bioadhesive formulations; Plant extracts; Thermogelling systems; Trichomoniasis; Vaginal bacteriosis; Vaginal dosage forms; Vulvovaginal candidosis