University Institute of Pharmaceutical Sciences, UGC Centre of Advanced Studies, Panjab University, Chandigarh, 160 014, India.
Curr Pharm Des. 2018;24(43):5108-5128. doi: 10.2174/1381612825666190118155843.
The therapeutic approaches for the management of topical infections have always been a difficult approach due to lack of efficacy of conventional topical formulations, high frequency of topical applications and non-patient compliance. The major challenge in the management of topical infections lies in antibiotic resistance which leads to severe complications and hospitalizations resulting in economic burden and high mortality rates.
Topical delivery employing lipid-based carriers has been a promising strategy to overcome the challenges of poor skin permeation and retention along with large doses which need to be administered systemically. The use of lipid-based delivery systems is a promising strategy for the effective topical delivery of antibiotics and overcoming drug-resistant strains in the skin. The major systems include transfersomes, niosomes, ethosomes, solid lipid nanoparticles, nanostructured lipid carriers, microemulsion and nanoemulsion as the most promising drug delivery approaches to treat infectious disorders. The main advantages of these systems include lipid bilayer structure which mimics the cell membrane and can fuse with infectious microbes. The numerous advantages associated with nanocarriers like enhanced efficacy, improvement in bioavailability, controlled drug release and ability to target the desired infectious pathogen have made these carriers successful.
Despite the number of strides taken in the field of topical drug delivery in infectious diseases, it still requires extensive research efforts to have a better perspective of the factors that influence drug permeation along with the mechanism of action with regard to skin penetration and deposition. The final objective of the therapy is to provide a safe and effective therapeutic approach for the management of infectious diseases affecting topical sites leading to enhanced therapeutic efficacy and patient-compliance.
由于常规局部制剂疗效不佳、局部应用频率高且患者顺应性差，局部感染的治疗方法一直是一个难题。局部感染管理的主要挑战在于抗生素耐药性，这导致严重的并发症和住院治疗，造成经济负担和高死亡率。
采用基于脂质的载体进行局部给药是克服经皮渗透和滞留差以及需要全身给予大剂量的一种很有前途的策略。基于脂质的传递系统是有效局部递抗生素和克服皮肤中耐药菌株的有前途的策略。主要系统包括传递体、非离子型脂质体、醇质体、固体脂质纳米粒、纳米结构脂质载体、微乳液和纳米乳液，这些系统是治疗感染性疾病最有前途的药物递送方法。这些系统的主要优点包括模仿细胞膜并能与感染微生物融合的脂质双层结构。纳米载体具有许多优点，如增强疗效、提高生物利用度、控制药物释放和靶向所需感染病原体的能力，使这些载体取得了成功。
尽管在感染性疾病的局部药物传递领域已经取得了许多进展，但仍需要广泛的研究努力，以更好地了解影响药物渗透的因素以及皮肤渗透和沉积的作用机制。治疗的最终目标是为影响局部部位的感染性疾病提供一种安全有效的治疗方法，从而提高治疗效果和患者顺应性。
