The Impact of Lactobacillus-Rich Probiotic Nutrition on the Pharmacological Efficacy of Clotrimazole Delivered via Mucoadhesive Thermosensitive Hydrogels in Human Subjects with Recurrent Candidiasis

This study involving 120 women with recurrent vulvovaginal candidiasis found that a triple-therapy approach—combining clotrimazole-loaded mucoadhesive thermosensitive hydrogels, Lactobacillus-rich probiotic nutrition, and fractional CO₂ laser therapy—yielded superior outcomes compared to other treatments. The triple therapy significantly reduced vaginal pH, decreased Candida load, and improved lactic acid concentration, vaginal epithelial thickness, moisture retention, and Vaginal Health Index scores. Scanning electron microscopy showed restored epithelial surface architecture and minimal fungal biofilm presence. The findings suggest that integrating microbiome restoration and laser therapy with pharmacological treatment offers a promising strategy for managing recurrent candidiasis, though further large-scale trials are needed to confirm long-term safety and efficacy.