The vaginal sheet: an innovative form of vaginal film for the treatment of vaginal infections

Vaginal Sheets with Thymbra capitata Essential Oil for the Treatment of Bacterial Vaginosis: Design, Characterization and In Vitro Evaluation of Efficacy and Safety

We aimed to incorporate Thymbra capitata essential oil (TCEO), a potent antimicrobial natural product against bacterial vaginosis (BV)-related bacteria, in a suitable drug delivery system. We used vaginal sheets as dosage form to promote immediate relief of the typical abundant vaginal discharge with unpleasant odour. Excipients were selected to promote the healthy vaginal environment reestablishment and bioadhesion of formulations, while the TCEO acts directly on BV pathogens. We characterized vaginal sheets with TCEO in regard to technological characterization, predictable in vivo performance, in vitro efficacy and safety. Vaginal sheet D.O (acid lactic buffer, gelatine, glycerine, chitosan coated with TCEO 1% w/w) presented a higher buffer capacity and ability to absorb vaginal fluid simulant (VFS) among all vaginal sheets with EO, showing one of the most promising bioadhesive profiles, an excellent flexibility and structure that allow it to be easily rolled for application. Vaginal sheet D.O with 0.32 µL/mL TCEO was able to significantly reduce the bacterial load of all in vitro tested Gardnerella species. Although vaginal sheet D.O presented toxicity at some concentrations, this product was developed for a short time period of treatment, so this toxicity can probably be limited or even reversed when the treatment ends.

Formulation and in vitro and in vivo evaluation of surfactant-stabilized mucoadhesive nanogels for vaginal delivery of fluconazole

Surfactant-stabilized mucoadhesive nanogels (NGs) for vaginal delivery of fluconazole (FLZ) were studied and evaluated in this work. FLZ-NG formulations were prepared using two different types of mucoadhesive polymers, Carbopol 934 (Ca934) and Pluronic F-127 (PF127). A rheology study revealed a non-Newtonian pseudoplastic flow behavior (shear thinning) in the prepared NGs. The viscosity of Ca934 NG (0.47 Pa s) was much lower compared to the PF127 NG (6.10 Pa s). The rheology study results correlated well with the in vitro FLZ release profile from the NG formulations. A pH study (pH = 3.90-4.90) revealed that the formulations were physiologically suitable for vaginal application, to avoid the irritation of the vaginal mucosa. Finally, in vitro and in vivo antimicrobial tests were performed. FLZ incorporated into the Ca934 gel had the strongest antimicrobial effect, with a mean inhibition zone of 24 ± 1.6 mm. Based on these results, it was concluded that the mucoadhesive NG incorporating FLZ resulted in a sustained release and enhanced antimicrobial effect, which would enhance and prolong the therapeutic effects of vaginally delivered FLZ.

Effect of Dexamethasone and Route of Administration on Sow Farrowing Behaviours, Piglet Delivery and Litter Performance

The inflammatory pain and stress some crated sows experience during farrowing has attendant risks of piglet-directed aggression, reduced teat exposure and hindered post-partum recovery. To counter this, the steroidal anti-inflammatory compound, dexamethasone, can be administered. To measure the potential for mucosal absorption as an alternative to injection, the permeability of porcine vaginal mucosa to dexamethasone was demonstrated using Franz cell diffusion. These studies found dexamethasone treatment diffused through vaginal mucosa at a constant rate, with 52.37 ± 5.54% permeation in 6 h. To examine in vivo effects on farrowing outcomes, dexamethasone was administered to gilts and parity one sows on the day of expected farrowing. We hypothesized that it would provide relief from farrowing discomfort and reduce behaviours threatening piglet survival. Sows were randomly assigned to receive dexamethasone as an intramuscular injection (n = 23); dexamethasone applied topically into the vagina (n = 20), or to receive no dexamethasone (n = 23). Sows (n = 66) and piglets (n = 593) were monitored for performance indicators during farrowing and early lactation. A subset of sows (n = 24) was also video monitored continuously over 24 h for behaviours associated with pain, postural changes and piglet interactions. No differences were observed between treatment for farrowing performance, piglet survival or behavioural changes for sows experiencing their first or second farrowing (p > 0.05), rejecting the hypothesis that corticosteroid administration will improve sow farrowing performance. This investigation did, however, show that dexamethasone can permeate through porcine vaginal mucosa and so can be administered as a non-injectable treatment.

Identification of Escherichia coli strains in the vaginal cultures of healthy women and their patterns of antibiotic resistance

Background: Bacterial vaginosis is the most common cause of vaginitis in women of childbearing age, and it predominantly affects young sexually active women. Escherichia coli is one of the most common bacteria found in the genital tract of non-pregnant (9–28%) and pregnant women (24–31%). E. coli strains can colonize the vaginal and endocervical regions in pregnant women, and may lead to the development of urinary tract, intra-amniotic or puerperal infections. Aim of the study: Isolation and identification of the antibiotic resistance patterns of extended spectrum beta-lactamase (ESBL)-producing and non-producing E. coli in the vaginal cultures of healthy women. Material and methods: Vaginal samples were taken from 55 healthy women. For the bacterial identification and resistance patterns, automated equipment from Beckman Coulter was used. Phenotypic techniques were used to confirm the presence or absence of ESBL. Results: Fifty-five cultures developed E. coli, with the rest of the strains corresponding to different bacteria. Of the 55 E. coli cultures, 35 (63.63%) were ESBL-producing and 20 (36.36%) did not produce ESBL. There was an 80% resistance to penicillin, and a 76.4% and 65.5% resistance to the first and fourth generation cephalosporins, respectively. A 45.5% resistance was observed for the fluoroquinolones, 52.7% for trimethoprim/ sulfamethoxazole, and 100% sensitivity to carbapenemics and amikacin. Conclusions: A large presence of vaginal ESBL-producing E. coli was observed in healthy women, which increases the risk of therapeutic failure due to high levels of antibiotic resistance.

A review: Gelatine as a bioadhesive material for medical and pharmaceutical applications

Bioadhesive polymers offer versatility to medical and pharmaceutical inventions. The incorporation of such materials to conventional dosage forms or medical devices may confer or improve the adhesivity of the bioadhesive systems, subsequently prolonging their residence time at the site of absorption or action and providing sustained release of actives with improved bioavailability and therapeutic outcomes. For decades, much focus has been put on scientific works to replace synthetic polymers with biopolymers with desirable functional properties. Gelatine has been considered one of the most promising biopolymers. Despite its biodegradability, biocompatibility and unique biological properties, gelatine exhibits poor mechanical and adhesive properties, limiting its end-use applications. The chemical modification and blending of gelatine with other biomaterials are strategies proposed to improve its bioadhesivity. Here we discuss the classical approaches involving a variety of polymer blends and composite systems containing gelatine, and gelatine modifications via thiolation, methacrylation, catechol conjugation, amination and other newly devised strategies. We highlight several of the latest studies on these strategies and their relevant findings.

Recent Advances in Polymer-Based Vaginal Drug Delivery Systems

The vagina has been considered a potential drug administration route for centuries. Most of the currently marketed and investigated vaginal formulations are composed with the use of natural or synthetic polymers having different functions in the product. The vaginal route is usually investigated as an administration site for topically acting active ingredients; however, the anatomical and physiological features of the vagina make it suitable also for drug systemic absorption. In this review, the most important natural and synthetic polymers used in vaginal products are summarized and described, with special attention paid to the properties important in terms of vaginal application. Moreover, the current knowledge on the commonly applied and innovative dosage forms designed for vaginal administration was presented. The aim of this work was to highlight the most recent research directions and indicate challenges related to vaginal drug administrations. As revealed in the literature overview, intravaginal products still gain enormous scientific attention, and novel polymers and formulations are still explored. However, there are research areas that require more extensive studies in order to provide the safety of novel vaginal products.