In-vivo Studies on Sustained Release Systems for Delivering Antimycotics. A Systematic Review focused on Oral Candidiasis treatment.

Abstract

<h4>Background</h4>Oral candidiasis (OC) is the most common infection in patients wearing polymer-based dentures. Sustained-release systems for delivery (SRSDs) have been proposed as anti-OC therapeutics. Therefore, this systematic review aimed to determine which SRDS showed better antifungal results in in vivo models.<h4>Material and methods</h4>Electronic literature searches were conducted using PubMed/MEDLINE, Web of Science, and Google Scholar databases, limited to January 1, 1989, to May 31, 2025. The MeSH terms (PubMed) utilized included drug delivery systems, phytochemicals, plant extracts, herbal medicines, phytometabolites, antifungal agents, azoles, nystatin, macrolides, Candida spp., oral candidiasis, oral candidosis, Candida albicans, and Candida glabrata. Articles were included whose experimental design was in vivo or ex vivo models and whose objective was to determine the efficacy of sustained release systems as an anti-Candida treatment.<h4>Results</h4>A total of 137 articles were retrieved and 125 were discarded because they did not match the principal objective of the study or did not meet the inclusion criteria. Twelve observational studies involving humans (adults aged 18 years) or animal models exposed to antifungal SRDSs were included. The most frequently used SRDSs were buccal mucoadhesive gel, mucoadhesive buccal tablets, and nanoparticles, while the most commonly used biomaterials were the bioadhesive polymers HPMC, NaCMC, carbopol 934, and sodium alginate. All antifungals incorporated in the SRDSs showed antifungal efficiency.<h4>Conclusions</h4>Chitosan-coated bioadhesive polymers are the most promising options for treating OC.