Skin Infection is the most common condition in the ambulatory care. [1] Skin is the largest organ of the body, comprising up to 15% of the entire body weight. It performs various essential functions, including protection against external, physical, chemical, and biological agents, as well as prevention of excess water loss from the body and a role in thermoregulation. It is made up of three layers i.e., Epidermis, Dermis, Subcutaneous layer. [2]
Skin infection is caused due to microbial invasion of the skin and underlying tissues and depending on the severity of infection it can range from a from mild to serious life-threatening infections by just a tiny spot on the skin to the redness, swelling, pain, erythema onto the entire skin surface. The incidence of skin infections is increased due to rapidly growth in the number of aged populations, critically ill patients, immuno-compromised patients and also due to the emergence of multi-drug resistant pathogen. [3]
Often Drugs (topical, oral or parenteral antibiotics) are prescribed on the basis of condition of the skin infection. In the Literature survey it was seen, in case of mild impetigo and follicutis Topical mupirocin is given. While remaining infections are usually managed by either incision or oral and intravenous antibiotics. [4] Patients with some sign of gastric problems are treated ith parenteral therapy. Whereas patients with nomal health conditions are treated with oral antibiotics. [5]
Due to lack of permeation of most of the antibiotic agents from the topical formulations into sub dermal tissues and deeper skin layers therefore infections are mainly treated using high doses of oral or parenteral dosage form and because of this high dose of the antibiotic classes, there are various disadvantages which are as follow [5, 6]
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Diarrhea- Most common in β lactams e.g., penicillin derived antibiotic, Cephalexin.
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Nausea, vomiting- Seen in almost every antibiotic therapy.
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Nephrotoxicity- Very common in Polypeptides e.g., Vancomycin.
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Myotoxicity- Seen in cyclic lipopeptide e.g., Daptomycin.
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Myelosuppression- Common in Linezolid.
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Acute pancreatitis – Seen after Glycylcyclines e.g., aztreonam, tigecycline.
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Mild thrombocytopenia- common in Oxazolidinones.
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Drug Resistant- Very common in antibiotic therapy e.g. Cephalexin, Linezolid etc.
To improve patient compliance and its efficacy drug delivery system with modified Various drug delivery system modifies drug release profile, absorption, distribution and elimination are used. Conventional dosage form was unable to meet any of these needs. Most common routes of administration include oral, topical (skin), transmucosal (nasal, buccal, sublingual, vaginal, ocular and rectal) and inhalation route.
Out of the various drug delivery system, vesicles as a drug carrier system have become the vehicle of choice. Lipid vesicles were mostly used in immune therapy, biology of membrane and diagnostic technique and also in genetic engineering. [7] It provides an efficient method for delivery of drug to infection site, leading to reduce drug toxicity with lesser adverse effects. It reduces therapy cost by improving bioavailability of medication, especially in case of poorly soluble drugs and also by reducing the dose and dosing frequency thereby improving patient compliance. In vesicles both hydrophilic and lipophilic drugs can be incorporated. [8]
Transferosomes is commonly known as “Ultra Deformable Vesicles” and it contain a lipid vesicle made up of Phospholipids and an edge activator. Transferosomes passes stratum corneum layer by squeezing themselves many times smaller than its size owing to its elasticity nature which is achieved by mixing suitable surface-active components and lipids [9]
Drug carrier can be engineered to slowly degrade, react to certain stimuli (pH, Temperature) and be site-specific. The ultimate aim is to control degradation of drug and loss, prevention of harmful side effects and increase the availability of the drug at the disease site. [10] Encapsulation of a drug in vesicular structures can be designed to prolong the existence of the drug in systemic circulation, and perhaps, reduces the toxicity. [11, 12]
Topical route is the most preferred route for mild skin infection but due to poor permeability of most antibiotic agents into sub dermal tissues and deeper skin layers these routes becomes ineffective for most drugs. Transferosomes or ultra-deformable vesicles are one of the most superior drug delivery system for topic and transdermal drug delivery. It is said to pass through the intact skin very efficiently and move deep enough through the various layers of the skin and also get absorbed into the systemic circulation. [13] Transferosomes in the size range of 200–300 nm are reported to easily penetrate through the skin. [14] Therefore by making Transferosomes of the drug and loading it into topical formulations many side effects can be avoided and the drug can reach under the layers of the skin as well as systemic circulation.