- lauraclark849
- Oct 8
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Opinion Article | Open Access | Published 8th October 2025
Development And Characterization Of Azithromycin-loaded Transdermal Patches For Enhanced Antibacterial Efficacy
Kunuku Srinu¹*, Medisetty Gayatri Devi², Pavitra D², Gowri Sankar Chintapalli¹,
K Surendra³, M Vinod Kumar⁴ EJPPS | 30303 (2025) https://doi.org/10.37521/ejpps30309
ABSTRACT
Transdermal drug delivery systems provide a convenient and patient-friendly alternative to oral or injectable formulations by administering medication continuously through the skin. To address antibiotic resistance and poor oral compliance, a transdermal patch for azithromycin, a broad-spectrum macrolide antibiotic, could improve therapeutic outcomes¹⁻³. Patches that circumvent first-pass metabolism and maintain steady plasma levels can reduce adverse effects, enhance patient compliance, and even prevent resistance development. This study describes the design, formulation, and evaluation of azithromycin-loaded transdermal patches. We selected matrix and drug-in-adhesive designs to control release and enhance skin penetration of this big chromophore molecule. Several excipients were optimized, including skin penetration enhancers (such as ethanol and surfactants), sticky polymers for comfort and consistent release, and stabilizers to keep the medicine intact during storage⁴⁻⁷. The manufacturing techniques investigated included solvent casting for cost-effectiveness, hot-melt extrusion for uniformity, and new 3D-printing options for precise dosage control. Patch thickness, weight uniformity, drug content, mechanical strength, and surface shape were all examined during physicochemical characterization. In vitro permeation investigations employing Franz diffusion cells revealed the appropriate medication flux over synthetic membranes and human skin equivalents. Cytotoxicity assays and skin irritation tests were used to assess safety, which were required before in vivo pharmacokinetic (PK) studies in animal models⁸⁻¹². Transdermal delivery achieved therapeutic plasma levels comparable to single oral dosages, with less peak-to-trough variability, according to PK investigations. Stability studies demonstrated that physical qualities, chemical potency, and microbiological integrity remained intact throughout lengthy storage. In the future, individualized "smart" patches with sensors and configurable release profiles could transform antibiotic therapy by allowing for real-time monitoring and dosage recommendations¹³⁻¹⁶. However, additional clinical trials and regulatory confirmation are required. In conclusion, azithromycin transdermal patches hold great promise for improving antibacterial therapy by increasing compliance, assuring consistent administration, and minimizing resistance. Continued improvement in formulation, manufacturing, and clinical evaluation could make these patches viable alternatives to traditional antibiotic regimens¹⁷⁻¹⁹.
Keywords: Azithromycin transdermal patch, Permeation enhancers, Matrix & drug-in-adhesive systems, In vitro permeation (Franz diffusion cells), Skin irritation and pharmacokinetics
INTRODUCTION
Transdermal drug delivery devices are a new method of administering medication to the body. Unlike pills and needles, transdermal patches adhere to the skin and gradually release medication over time. They provide a more convenient and often safer method of delivering medications, particularly for long-term treatment. Antibiotic resistance is on the rise, and many patients have difficulty adhering to oral medications¹, ²⁰⁻²⁴. New antibiotic delivery methods are required. Transdermal patches have the potential to revolutionize treatment by making it easier to administer and lowering adverse effects. The widely recognized antibiotic azithromycin is often employed to address various ailments. Taking it as a pill or injection might not always be the most effective approach, however. The use of a patch could improve the effectiveness of azithromycin and increase patient adherence. This article discusses the creation of azithromycin transdermal patches, the assessments required for them, and their possible uses in upcoming healthcare²⁵⁻³⁰.
The chemical structure of Azithromycin is:
Advantages of Transdermal vs Conventional Methods for Azithromycin Administration
Transdermal patches provide several advantages over injections and oral medications. Patients are advised to finish their treatment as it is easy to use. No longer visiting the doctor for vaccinations or taking drugs. Furthermore, these patches bypass the liver and stomach, where medications may be broken down before reaching the bloodstream³¹⁻³⁷. The first-pass effect is a mechanism that diminishes the potency of drugs. Patches provide a consistent dose of medication, ensuring stable levels in the bloodstream. This may reduce side effects and improve treatment outcomes³⁸⁻⁴¹.
Challenges in the Administration of Transdermal Antibiotics
Azithromycin has trouble passing through the skin. Things are kept out by the skin's powerful barrier. This barrier is tough for many antibiotics to overcome. Formulators must determine how to incorporate an adequate amount of azithromycin into the patch⁴²⁻⁴⁷. They have to control the drug's release rate to keep it effective without irritating the patient or producing negative side effects. Stability is another problem; patches must remain functional for months after being saved. Furthermore, safety is important since if there is any skin irritation or allergic reaction, the patch could not be appropriate for use⁴⁸⁻⁵².
Market Potential and Current Trends
The use of transdermal medicine administration is growing in popularity. Scientists are always developing innovative methods to improve skin absorption. Technology companies are investing in the development of innovative patches for a variety of drugs, including antibiotics⁵³⁻⁶⁰. The market for transdermal systems is projected to expand rapidly in the years to come. The success of fentanyl patches for pain relief, for instance, demonstrates the promise of this delivery system. The demand for efficient topical solutions, such as azithromycin patches, increases as antibiotic resistance increases⁶¹⁻⁶⁷.
FORMULATION STRATEGIES FOR AZITHROMYCIN TRANSDERMAL PATCHES
Selecting the Appropriate Patch Type
There are various patch designs, each appropriate for a certain medication. A medication solution is layered within reservoir patches. The medication is patched inside the sticky layer by matrix patches. The medicine is mixed directly into the sticky layer of drug-in-adhesive patches. Formulators usually favour matrix or drug-in-adhesive patches for azithromycin because of their regulated and consistent release. Because azithromycin is a quite big molecule, it is important to choose a patch that will increase its penetration⁶⁸⁻⁷³.
Important Excipients and Their Functions
Excipients improve the patch's performance. Ethanol and surfactants are examples of permeability enhancers that can facilitate azithromycin's skin penetration. Adhesives and polymers maintain the patch's stickiness, skin-friendliness, and regulated drug release⁷⁵⁻⁸¹.
Stabilizers prolong the shelf life of azithromycin by preventing its degradation over time. Choosing the perfect combination of these elements is akin to tuning a musical instrument; they need to harmonize effectively⁸²⁻⁸⁵.
Methods of Manufacturing
The simplest way of preparing patches is by solvent casting in which a mixture of drug and polymer is spread out into film on paper then dried to form patches or films as shown in Fig 1. Another approach to making uniform patches is to utilize heat rather than solvents, called hot-melt extrusion⁸⁶⁻⁸⁹. The 3D printing method of producing patches offers a novel means for control over drug release rate and distribution in the body through targeted delivery sites. A drug's characterization, cost and scale underpin all approaches. Each method has its own advantages and disadvantages⁹⁰⁻⁹³.
Typical Formulation Issues
Getting the right amount of Azithromycin into the patch isn’t easy and on top of that it can cause skin irritations. Excess doses would produce harmful effects; too small a dose will not do the job⁹⁴⁻⁹⁶. Transdermal patches present challenges related to storage and stability. It is essential to maintain their quality under varying environmental conditions to ensure an extended shelf life and consistent therapeutic efficacy. Yet the question is not just how long lifestyle changes must be maintained to achieve meaningful benefits. Yields must remain at a consistent level, even in storage and distribution⁹⁷⁻⁹⁹. Each batch must be reproducible and meet the same performance and safety criteria, so very tight controls on manufacturing are essential¹⁰⁰⁻¹⁰².
EVALUATION OF AZITHROMYCIN TRANSDERMAL PATCHES
Characterization of physicochemical properties get
The photochemical properties, such as photodegradation and fluorescence, depend on UV radiation, which may come from sunlight outdoors or from a photolamp indoors. At this stage of development, a number of guarantee steps are necessary. Thickness measurement and weight analysis are tablet quality control tests that measure thickness and weight uniformity of colchicine and perphenazine tablets. Durability and pliability of the patch are essential, since these features determine both how well it will be conformed to your body shape as you wear it for a night or two (pliability), as well as what happens during its days or weeks of life span (durability).
MICROSCOPIC ANALYSIS CAN REVEAL SURFACE FEATURES AND ENSURE NO IMPERFECTIONS
Permeation Studies in Vitro
For in vitro permeation studies Franz diffusion cells are used to examine azithromycin's in vitro diffusion ability. No matter whether the experiment employs synthetic membranes or human skin layers, this system can continuously test both how much time it takes for medicine to be absorbed into the body and how many total doses are given over a given length of time. To make this possible, the goal is that conditions should be right for maximum uptake of medicine with minimum pain.
Safety Concerns and Skin Irritation
Patches are tested for skin irritation before they can be used by humans. The question as to whether the patch causes redness or allergic reaction is answered through laboratory experiments on human or animal skin. Cytotoxicity tests determine whether the formulation damages cells, indicating potential toxicity.
In Vivo Pharmacokinetic Studies
These evaluations, in conjunction with future human studies and regulatory oversight, are expected to support validation of critical manufacturing parameters and facilitate expanded implementation. Animal models are used to look at absorption of the drug following patch application. These kinds of tests look at how much azithromycin is absorbed with a dose of 500 mg orally (Similar to what happens to chylomicrons during food intake) Plasma levels, measured accurately by liquid chromatography–mass spectrometry (LC-MS), are used to compare how much azithromycin enters the bloodstream from the transdermal patch with the known absorption profile of the standard 500 mg oral dose, ensuring stable therapeutic levels without harmful peaks The aim is to maintain a stable therapeutic level with no peaks - which would result in side-effects.
Testing for Stability
For extended stability evaluation, patches must be kept in various natural conditions. Patches should be periodically monitored using various testing methods to detect changes in physical properties, microbial contamination, and azithromycin stability. Various testing methods monitor changes in physical properties, infection by microbial organisms (particularly at the injection site) and breakdown of azithromycin. The results confirm that the patches will remain safe and effective throughout their shelf life.
Prospects for the Future and Clinical Consequences
The future of azithromycin patches lies in their potential for personalised therapy. For example, imagine living with patches such as these perhaps there might be sensors built in to monitor your body's infection load and medication dispensing. The provision of data to your doctor via these clever 'smart' patches in return permits exact adjustments. However, difficulties in regulation and stringent clinical trials yet to be completed are still problems. Early tests and case reports show promise, but further research.
CONCLUSION
It is important to ensure an effective connection between the patch design and azithromycin’s efficient delivery for safety, efficacy, and patient compliance. Using the appropriate combination of membrane permeation promoters, polymers, and production processes for antibiotics by means of topical administration are safe and practical. Examples of innovative technology that could assist penetration, dosing and feedback from the user include patch-integrated sensors with "smarts", vesicular carriers (transethosomes, invasomes) and asymmetric porous membranes. In this context, “smarts” refers to integrated technologies within the patch, including sensors and microdevices, that can track drug absorption, provide real-time feedback, regulate dosing according to patient or skin needs, monitor treatment adherence, and transmit data to healthcare providers for improved safety and effectiveness.
Whether compliance can be improved and side effects reduced depends on novel patch designs that enhance convenience, dosing control, and skin safety, while also potentially helping to combat antibiotic-resistant bacteria. Researchers should develop transdermal drugs for better skin penetration, longer-lasting therapeutic effects, and improved safety features. With azithromycin patches, instead of being treated in hospital for infections one could have more convenient and patient-friendly treatments provided innovation continues. To make this vision a reality, we need clinical trials and immediate monitoring, not just more money. New production methods also must be devised.
References
1. Chintapalli Gowri Sankar Kirtimaya Mishra, Snigdha Rani Behera, Tikeswari Majhi. Binodini Majhi, Itraconazole: A literature review on analytical and bio-analytical methods. International Journal of Research in Pharmacy and Pharmaceutical Sciences. 2021;6(2):08-12.
2. Mukherjee B, Mahapatra S, Gupta R, Patra B, Tiwari A, Arora P. A comparison between povidone-ethylcellulose and povidone-eudragit transdermal dexamethasone matrix patches based on in vitro skin permeation. European Journal of Pharmaceutics and Biopharmaceutics. 2005 Apr;59(3):475–83.
3. Sun Y, Du L, Liu Y, Li X, Li M, Jin Y, et al. Transdermal delivery of the in situ hydrogels of curcumin and its inclusion complexes of hydroxypropyl-β-cyclodextrin for melanoma treatment. International Journal of Pharmaceutics. 2014;469:31-39.
4. Gowri Sankar Chintapalli, Snigdha Rani Behera, Diptimayee Jena, Parbati Tripathy, Abhilash Dash and Kirtimaya Mishra. Design Development and Evaluation of Pulsatile Drug Delivery System of Orciprenaline Sulfate for the Treatment of Nocturnal Asthma. Indian Journal of Natural Sciences. 2023;14(77):54108- 54117.
5. K.Srinu, M. Gayatri Devi, D. Pavitra. Formulation and Evaluation of Naproxen Sodium Transdermal Patches. Journal of Emerging Technologies and Innovative Research. 2024;11(11):273-292.
6. Chintapalli Gowri Sankar, SR Behera, Sruti Ranjan Mishra, M Somesu, B Kiran Kumar, Kirtimaya Mishra. Design and evaluation of floating microspheres of ranitidine hcl. The pharma innovation journal. 2020;9(3):223-33.
7. Panda, S., & Das, S. (2022). Formulation and evaluation of inclusion complexed repaglinide with β-cyclodextrin transdermal patches. International Journal of Health Sciences, 6(S1), 12812–12824, https://doi.org/10.53730/ijhs.v6nS1.8590.
8. Monika B, Amit R, Sanjib B, Alisha B, Mihir P, Dhanushram T. Transdermal drug delivery system with formulation and evaluation aspects: overview. Research Journal of Pharmacy and Technology. 2012;5(9):1168–76.
9. Meriem Rezigue, Hadeia Mashaqbeh, Alaa A A Aljabali, Randa SH Mansour, Iyad Hamzeh. Development and Evaluation of Azithromycin-Loaded Transethosomes for Enhanced Dermal Delivery and Antibacterial Efficacy. Pharamaceutics, 2025;(17):(400)1-25.
10. Ahlam Zaid Alkilani, Batool Musleh, Rania Hamed, Lubna Swellmeen and Haneen A. sheer. Preparation and Characterization of Patch Loaded with Clarithromycin Nanovesicles for Transdermal Drug Delivery. Journal of Functional Biomaterials. 2023;14(2):(57)1-21.
11. Yong-Hong Qin, Hai-Sheng Jiao, Ai-Shu Li, Yang Jiao, Li-Ming Wei, Jin Zhang, Lin Zhong, Kai Liu, Xuan-Fen Zhang. Transdermal application of azithromycin-amlodipine-heparin gel enhances survival of infected random ischaemic flap. Journal of Plastic Surgery and Hand Surgery. 2015;49(6): 319-326.
12. Mahya Samari, Soheila Kashanian, Sirus Zinadini, Hossein Derakhshankhah. High-performance azithromycin delivery via chitosan-tryptophan modified polyethersulfone transdermal membranes. Carbohydrate Polymer Technologies and Applications. 2025;11:100911.
13. Ahlam Zaid Alkilani, Rania Hamed, Batool Musleh, Zaina Sharaire. Breaking boundaries: the advancements in transdermal delivery of antibiotics. Drug Delivery. 2024;31(1):( 2304251)1-15.
14. Kunuku Srinu, S. Sravani. A Review on Gastroretentive Drug Delivery System. International Journal for Research in Applied Science and Engineering Technology. 2024;12(11):2084-2088.
15. Sonia Tomar, Tinku Singhal, Formulation and Evaluation of Topical Gel Containing Azithromycin and Prednisolone Vesicles for Treating Psoriasis. International Journal of Pharmaceutical Research and Allied Sciences. 2015;4(4):45-58.
16. Mahya Samari, Soheila Kashanian, Sirus Zinadini, Hossein Derakhshankhah. Enhanced delivery of azithromycin using asymmetric polyethersulfone membrane modified with KIT-6 mesoporous material. European Journal of Pharmaceutical Sciences. 2025;207.
17. Masumeh Nasrollahzadeh, Fariba Ganji, Seyed Mojtaba Taghizadeh, Ebrahim Vasheghani-Farahani, Mahsa Mohiti-Asli. Drug in adhesive transdermal patch containing antibiotic-loaded solid lipid nanoparticles. Journal of Bioscience and Bioengineering. 2022;134(5):471-476.
18. Ahlam Zaid Alkilani, Maelíosa TC Mc Crudden, Ryan F Donnelly, Transdermal Drug Delivery: Innovative Pharmaceutical Developments Based on Disruption of the Barrier Properties of the stratum corneum. Pharmaceutics. 2015;7:438-470.
19. Anselmo, A.C., Mitragotri, S. An Overview of Clinical and Commercial Impact of Drug Delivery Systems. J. Control. Release, 2014;190:15–28.
20. Ita, K. Transdermal Drug Delivery: Progress and Challenges. J. Drug Deliv. Sci. Technol. 2014;24:245–250.
21. Echeverría-Esnal D, Martin-Ontiyuelo C, Navarrete-Rouco ME, De-Antonio Cuscó M, Ferrández O, Horcajada JP, Grau S. Azithromycin in the treatment of COVID-19: a review. Expert Rev Anti Infect Ther. 2021;19(2):147-163.
22. Chorin E, Dai M, Shulman E, Wadhwani L, Bar-Cohen R, Barbhaiya C, Aizer A, Holmes D, Bernstein S, Spinelli M, Park DS, Chinitz LA, Jankelson L. The QT interval in patients with COVID-19 treated with hydroxychloroquine and azithromycin. Nat Med. 2020;26(6):808-809.
23. Donnelly R.F, Singh T.R.R, Garland M.J, Migalska K, Majithiya R, McCrudden C.M, Kole P.L, Mahmood T.M.T, McCarthy H.O, Woolfson A.D. Hydrogel‐Forming Microneedle Arrays for Enhanced Transdermal Drug Delivery. Adv. Funct. Mater. 2012;22:4879–4890.
24. Million M, Lagier JC, Gautret P, et al. Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille France. Travel Med Infect Dis. 2020;35: 101738.
25. Gratieri T, Alberti I, Lapteva M, Kalia Y.N. Next Generation Intra-and Transdermal Therapeutic Systems: Using Non-and Minimally-Invasive Technologies to Increase Drug Delivery into and Across the Skin. Eur. J. Pharm. Sci. 2013;50:609–622.
26. Delgado, C. L. D., Rodríguez-Cruz, I. M., & Lopez-Cervantes, M. The skin: a valuable route for administration of drugs. In Current Technologies To Increase The Transdermal Delivery Of Drugs. Bentham Science Publishers. 2010;1:1-22.
27. Sherwood A, Bower JK, McFetridge-Durdle J, Blumenthal JA, Newby LK, Hinderliter AL. Age moderates the short-term effects of transdermal 17beta-estradiol on endothelium-dependent vascular function in postmenopausal women. Arterioscler Thromb Vasc Biol. 2007;27(8):1782–1787.
28. Rehman K, Zulfakar MH. Recent advances in gel technologies for topical and transdermal drug delivery. Drug Dev Ind Pharm. 2014;40(4):433–440.
29. Garala K. C., Shinde A. J., and Shah P. H. Formulation and in-vitro characterization of monolithic matrix transdermal systems using HPMC/Eudragit S 100 polymer blends. International Journal of Pharmacy and Pharmaceutical Sciences. 2009;1(1):108–120.
30. Lec S. T., Yac S. H., Kim S. W., and Berner B. One way membrane for transdermal drug delivery system. II. System optimization. International Journal of Pharmaceutics. 1991;77(2-3):231–237.
31. Stephen C. Aronoff, Chantal Laurent, Michael R. Jacobs. In-vitro activity of erythromycin, roxithromycin and CP 62993 against common paediatric pathogens. Journal of Antimicrobial Chemotherapy. 1987;19(2):275–276.
32. Lowe, John et al., Azithromycin therapy for prevention of chronic lung disease of prematurity (AZTEC): a multicentre, double-blind, randomised, placebo-controlled trial. The Lancet Respiratory Medicine. 2024;12(8): 608-618.
33. Simpson, SJ ∙ Du Berry, C ∙ Evans, DJ ∙ et al. Unravelling the respiratory health path across the lifespan for survivors of preterm birth. Lancet Respir Med. 2024;12(2):167-180
34. Roberts AR, Vallabhaneni N, Russi BW, Delaney KM, Leiding JW, Sochet AA. Azithromycin for Critically Ill Children with Bronchiolitis: A U.S. Pediatric Health Information Systems Registry Study, 2013-2022. Pediatr Crit Care Med. 2025;(5):708-717.
35. Liuyang Wang, Junyao Ma, Jiaxin Li, Liang Fang &Chao Liu. Transdermal patch based on pressure-sensitive adhesive: the importance of adhesion for efficient drug delivery. Expert Opinion on Drug Delivery. 2025;( 3):405-420.
36. Francesco Cilurzo PhD, Chiara G M Gennari PhD, Paola Minghetti PhD, Adhesive properties: a critical issue in transdermal patch development, Expert Opinion on Drug Delivery, 2012, Volume 9, Issue 1, Pages:33-45.
37. Ansa Ashfaqa, Tehseen Riaz, Muhammad Ahsan Waqar, Muhammad Zaman &Imtiaz Majeed, A comprehensive review on transdermal patches as an efficient approach for the delivery of drug, Polymer-Plastics Technology and Materials, 2024, Volume:63, Issue:8, Pages:1045-1069.
38. Ansa Abdul Razzaq, Tehseen Riaz, Muhammad Zaman, Muhammad Ahsan Waqar, Ansa Ashfaq. Recent advancements and various potential applications of transdermal patches. International Journal of Polymeric Materials and Polymeric Biomaterials. 2024; 73(17):1488-1499.
39. Marc B. Brown,Gary P. Martin,Stuart A. Jones &Franklin K. Akomeah. Dermal and Transdermal Drug Delivery Systems: Current and Future Prospects. Drug Delivery. 2006;13(3):175-187.
40. Kalpana S Paudel, Mikolaj Milewski, Courtney L Swadley, Nicole K Brogden, Priyanka Ghosh &Audra L Stinchcomb. Challenges and Opportunities in dermal/transdermal Delivery. Therapeutic Delivery. 2010;1(1):109-131.
41. Andrej Kováčik, Monika Kopečná, Kateřina Vávrová. Permeation enhancers in transdermal drug delivery: benefits and limitations. Expert Opinion on Drug Delivery. 2020;17(2):145-155.
42. Mohit Kumar, Ankita Sharma, Syed Mahmood, Anil Thakur, Mohd Aamir Mirza &Amit Bhatia. Franz diffusion cell and its implication in skin permeation studies. Journal of Dispersion Science and Technology. 2024;45(5):943-956.
43. Vamshi Krishna Rapalli, Arisha Mahmood, Tejashree Waghule, Srividya Gorantla, Sunil Kumar Dubey, Amit Alexander. Revisiting techniques to evaluate drug permeation through skin. Expert Opinion on Drug Delivery. 2021;18(12):1829-1842.
44. Amit K. Jain, Sakshi Jain, Mohammed A. S. Abourehab, Parul Mehta, Prashant Kesharwani. An insight on topically applied formulations for management of various skin disorders. Journal of Biomaterials Science. Polymer Edition, 2022;33(18):2406-2432.
45. Shweta Kumari, Prabhat Kumar Choudhary, Rahul Shukla, Amirhossein Sahebkar, Prashant Kesharwani. Recent advances in nanotechnology-based combination drug therapy for skin cancer. Journal of Biomaterials Science. Polymer Edition, 2022;33(11):1435-1468.
46. Dada KS, Elangwe CN, Olekhnovich RO, Nosova AO, Uspenskaya MV. Exploring the influence of mechanical and physical characteristics on transdermal patches: A study on polymeric films composed of hyaluronic acid and zinc oxide nanoparticles. Proceedings of the Voronezh State University of Engineering Technologies. 2024;86(3):282-288.
47. Shengnan Yin, Xiaofeng Chen, Runze Li, Linlin Sun, Chanyu Yao, Zheng Li. Wearable, Biocompatible, and Dual-Emission Ocular Multisensor Patch for Continuous Profiling of Fluoroquinolone Antibiotics in Tears. ACS Nano. 2024;18(28):18522–18533.
48. Prausnitz MR, Langer R. Transdermal drug delivery. Nature Biotechnology. 2008;(11):1261–1268.
49. Prausnitz MR, Mitragotri S, Langer R. Current status and future potential of transdermal drug delivery. Nature Reviews Drug Discovery. 2004;3(2):115–124.
50. Williams AC, Barry BW. Penetration enhancers. Advanced Drug Delivery Reviews. 2004;56(5):603–618.
51. Surabhi G, Basavaraj BV. Formulation and evaluation of azithromycin transdermal patches using different polymers. International Journal of Pharmacy and Pharmaceutical Sciences. 2015;7(6):389–393.
52. Nanda RK, Kharat AR, Gadakh SM. Formulation and evaluation of azithromycin transdermal drug delivery system. Journal of Drug Delivery and Therapeutics. 2014;4(4):119–123.
53. Ventola CL., The antibiotic resistance crisis: part 1: causes and threats. Pharmacy and Therapeutics. 2015;40(4):277–283.
54. Saddik MS, Elsayed MMA, El Mokhtar MA, Sedky H, Abdel Aleem JA, Abu Dief AM, Al Hakkani MF, Hussein HL, Al Shelkamy SA, Meligy FY. Tailoring of Novel Azithromycin Loaded Zinc Oxide Nanoparticles for Wound Healing. Pharmaceutics. 2022;14(1):111.
55. Abruzzo A, Parolin C, Rossi M, Vitali B, Cappadone C, Bigucci F. Development and Characterization of Azithromycin Loaded Microemulsions: A Promising Tool for the Treatment of Bacterial Skin Infections. Antibiotics (Basel). 2022;11(8):1040.
56. Ahlam Zaid Alkilani, Rania Hamed, Hajer Abdo, Lubna Swellmeen, Haneen A. Basheer, Walaa Wahdan, Amani D. Abu Kwiak. Formulation and Evaluation of Azithromycin Loaded Niosomal Gel: Optimization, In Vitro Studies, Rheological Characterization, and Cytotoxicity Study. ACS Omega. 2022;7(9):7628–7640.
57. Liu X, Li Z, Wang X, Chen Y, Wu F, Men K, Xu T, Luo Y, Yang L. Novel Antimicrobial Peptide Modified Azithromycin Loaded Liposomes Against MRSA. International Journal of Nanomedicine. 2016;11:6781–6794.
58. M Rezigue, H Mashaqbeh, AAA Aljabali, RSH Mansour, I Hamzeh. Development and Evaluation of Azithromycin Loaded Transethosomes for Enhanced Dermal Delivery and Antibacterial Efficacy. Pharmaceutics. 2025;17(4):400.
59. Tomar S, Singhal T. Pre-formulation studies of niosomal gel of prednisolone & azithromycin for topical drug delivery system. Journal of Innovations in Pharmaceuticals and Biological Sciences. 2015;2(3):312–321.
60. Chen Q, Yin C, Ma J, Tu J, Shen Y. Preparation and evaluation of topically applied azithromycin based on sodium hyaluronate in treatment of conjunctivitis. Pharmaceutics. 2019;11(4):183.
61. Rukavina Z, Jøraholmen MW, Božić D, Frankol I, Gašparović PG, Škalko Basnet N, Klarić MŠ, Vanić Žc. Azithromycin loaded liposomal hydrogel: enhanced treatment of MRSA related skin infections. Acta Pharm. 2023;73(4):559–579.
62. Alkilani AZ, Nasereddin J, Hamed R, Nimrawi S, Hussein G, Abo Zour H, Donnelly RF. Beneath the skin: a review of current trends and future prospects of transdermal drug delivery systems. Pharmaceutics. 2022;14c(6): 1152.
63. Raval, M., Bagada, H. et al., Formulation and Evaluation of Cyclodextrin-Based Thermosensitive in Situ Gel of Azithromycin for Periodontal Delivery. Journal of Pharmaceutical Innovation. 2019;16:67–84.
64. Bhattacharyya S, Reddy P. Effect of surfactant on azithromycin dihydrate loaded stearic acid solid lipid nanoparticles. Turkish Journal of Pharmaceutical Sciences. 2019;16(4):425–431.
65. Bangham AD, Godin B, Touitou E. Development and evaluation of azithromycin loaded transethosomes for enhanced dermal delivery and antibacterial efficacy. Pharmaceutics. 2025;17(4):400.
66. Ewelina Musielak, Violetta Krajka Kuźniak. Liposomes and ethosomes: comparative potential in enhancing skin permeability for therapeutic applications. Cosmetics. 2024;11(6):191.
67. MS Arshad, AT Zahra, S Zafar, H Zaman, A Akhtar, MM Ayaz, I Kucuk, M Maniruzzaman. Antibiofilm effects of macrolide-loaded microneedle patches. Pharmaceutical Research. 2021;38(1):165-177.
68. Tomar S, Singhal T. Preformulation studies of niosomal gel of prednisolone & azithromycin for topical delivery. Journal of Innovations in Pharmaceuticals and Biological Sciences. 2015;2(3):312–321.
69. Bhattacharyya S, Reddy P. Effect of surfactant on azithromycin dihydrate loaded stearic acid solid lipid nanoparticles. Turkish Journal of Pharmaceutical Sciences. 2019;16(4):425–431.
70. Tomar S, Singhal T. Preformulation studies of niosomal gel of prednisolone & azithromycin for topical drug delivery system. Journal of Innovations in Pharmaceuticals and Biological Sciences. 2015;2(3):312–321.
71. Abruzzo A, Parolin C, Rossi M, Vitali B, Cappadone C, Bigucci F. Development and characterization of azithromycin-loaded microemulsions. Antibiotics. 2022;11(8):1040.
72. Eid HM, Naguib IA, Alsantali RI, Alsalahat I, Hegazy AM. Novel chitosan coated niosomal formulation for improved management of bacterial conjunctivitis. Journal of Pharmaceutical Sciences. 2021;110(8):3027–3036.
73. Rukavina Z, Segic Klaric M, Filipovic Grcic J, Lovric J, Vanic Z. Azithromycin loaded liposomes for enhanced topical treatment of methicillin resistant Staphylococcus aureus (MRSA) infections. International Journal of Pharmaceutics. 2018;553:109–119.
74. Alrashedi MG, Ahmed OA, Ibrahim IM. Local delivery of azithromycin nanoformulation attenuated acute lung injury in mice. Molecules. 2022;27(23):8293.
75. Ritu Mehra Gilhotra, Kalpana Nagpal. Dina Nath Mishra,Azithromycin novel drug delivery system for ocular application. Int J Pharm Investig. 2011;1(1):22–28.
76. Elsayed MM, Abdallah OY, Naggar VF, Khalafallah NM. Deformable liposomes and ethosomes as carriers for skin delivery of ketotifen. An International Journal of Pharmaceutical Sciences. 2007; 62(2):133-137.
77. Moolakkadath T, Aqil M, Ahad A, Imam SS, Iqbal B, Sultana Y, Mujeeb M, Iqbal Z. Development of transethosomes formulation for dermal fisetin delivery. Artif Cells Nanomed Biotechnol. 2018;46(sup2:755-765.
78. Ascenso A, Raposo S, Batista C, Cardoso P, Mendes T, Praça FG, Bentley MV, Simões S. Development, characterization, and skin delivery studies of related ultrade formable vesicles. Int J Nanomedicine. 2015;10:5837-5851.
79. Akl MA, Eldeen MA, Kassem AM. Beyond Skin Deep: Phospholipid-Based Nanovesicles as Game-Changers in Transdermal Drug Delivery. AAPS Pharm Sci Tech. 2024;25(6):184.
80. Natsheh H, Touitou E. Phospholipid Vesicles for Dermal/Transdermal and Nasal Administration of Active Moleculesy. Molecules. 2020;25(13):2959.
81. Jafari A, Daneshamouz S, Ghasemiyeh P, Mohammadi-Samani S. Ethosomes as dermal/transdermal drug delivery systems. J Liposome Res. 2023;33(1):34-52.
82. Yang L, Wu L, Wu D, Shi D, Wang T, Zhu X. Mechanism of transdermal permeation promotion of lipophilic drugs by ethosomes. Int J Nanomedicine. 2017;12:3357-3364.
83. Nainwal N, Jawla S, Singh R, Saharan VA. Transdermal applications of ethosomes. J Liposome Res. 2019;29(2):103-113.
84. Mahajan K, Sharma P, Abbot V, Chauhan K. Ethosomes as a carrier for transdermal drug delivery system. J Liposome Res. 2024;34(4):697-714.
85. Hameed H, Faheem S, Khan MA, Hameed A, Ereej N, Ihsan H. Ethosomes: a potential nanovesicular carrier to enhancing the drug delivery against skin barriers. J Microencapsul. 2024;41(3):204-225.
86. Bodade SS, Shaikh KS, Kamble MS, Chaudhari PD. A study on ethosomes as mode for transdermal delivery of an antidiabetic drug. Drug Deliv. 2013;20(1):40-46.
87. Paiva-Santos AC, Silva AL, Guerra C, Peixoto D, Pereira-Silva M, Zeinali M, Mascarenhas-Melo F, Castro R, Veiga F. Ethosomes as Nanocarriers for the Development of Skin Delivery Formulations. Pharm Res. 2021;38(6):947-970.
88. Sharma G, Goyal H, Thakur K, Raza K, Katare OP. Novel elastic membrane vesicles (EMVs) and ethosomes-mediated effective topical delivery of aceclofenac: a new therapeutic approach for pain and inflammation. Drug Deliv. 2016;23(8):3135-3145.
89. Shakeel F, Baboota S, Ahuja A, Ali J, Aqil M, Shafiq S. Nanoemulsions as vehicles for transdermal delivery of aceclofenac. AAPS PharmSciTech. 2007;8(4): E104.
90. Musakhanian J, Osborne DW. Understanding Microemulsions and Nanoemulsions in (Trans)Dermal Delivery. AAPS PharmSciTech. 2025;26(1):31.
91. Ita Kevin. Progress in the use of microemulsions for transdermal and dermal drug delivery. Pharm Dev Technol. 2017;22(4):467-475.
92. Abdellatif AA, Tawfeek HM. Transfersomal Nanoparticles for Enhanced Transdermal Delivery of Clindamycin. AAPS PharmSciTech. 2016;17(5):1067-1074.
93. Zaker H, Taymouri S, Mostafavi A. Formulation and physicochemical characterization of azithromycin-loaded cubosomes. Res Pharm Sci. 2022;18(1):49-58.
94. Amin F, Khan S, Shah SMH, Rahim H, Hussain Z, Sohail M, Ullah R, Alsaid MS, Shahat AA. A new strategy for taste masking of azithromycin antibiotic: development, characterization, and evaluation of azithromycin titanium nanohybrid for masking of bitter taste using physisorption and panel testing studies. Drug Des Devel Ther. 2018;8(12):3855-3866.
95. Tung NT, Tran CS, Nguyen TL, Hoang T, Trinh TD, Nguyen TN. Formulation and biopharmaceutical evaluation of bitter taste masking microparticles containing azithromycin loaded in dispersible tablets. Eur J Pharm Biopharm. 2018;126:187-200.
96. Kunuku Srinu. Innovations In Pulmonary Drug Delivery: A Comprehensive Guide to Inhalation Devices. Journal Of Emerging Technologies And Innovative Research. 2024;11(9):E733-742.
97. Amrol D. Single-dose azithromycin microsphere formulation: a novel delivery system for antibiotics. Int J Nanomedicine. 2007;2(1):9-12.
98. Phatale V, Vaiphei KK, Jha S, Patil D, Agrawal M, Alexander A. Overcoming skin barriers through advanced transdermal drug delivery approaches. J Control Release. 2022;351:361-380.
99. Rizwan M, Aqil M, Talegaonkar S, Azeem A, Sultana Y, Ali A. Enhanced transdermal drug delivery techniques: an extensive review of patents. Recent Pat Drug Deliv Formul. 2009;3(2):105-124.
100. Tiwary AK, Sapra B, Jain S. Innovations in transdermal drug delivery: formulations and techniques. Recent Pat Drug Deliv Formul. 2007;1(1):23-36.
101. Nounou MI, El-Khordagui LK, Khalafallah NA, Khalil SA. Liposomal formulation for dermal and transdermal drug delivery: past, present and future. Recent Pat Drug Deliv Formul. 2008;2(1):9-18.
102. Dubey V, Mishra D, Nahar M, Jain NK. Vesicles as tools for the modulation of skin permeability. Expert Opin Drug Deliv. 2007;4(6):579-593.
Author Information
Authors: Kunuku Srinu¹*, Medisetty Gayatri Devi², Pavitra D², Gowri Sankar Chintapalli¹,
K Surendra³, M Vinod Kumar⁴
¹'¹*School of Pharmaceutical Sciences, Centurion University of Technology and Management, Vizianagaram, AP.
²Viswanadha Institute of Pharmaceutical Sciences, Visakhapatnam, AP.
³Department of Physics, Centurion University of Technology and Management, Vizianagaram, Andhra Pradesh, India.
⁴Department of Anaesthesia, Centurion University of Technology and Management, Vizianagaram, Andhra Pradesh, India.
Corresponding Author: Kunuku Srinu
Address: School of Pharmaceutical Sciences, Centurion University of Technology and Management, Vizianagaram, AP.
Email: srinukunuku@cutmap.ac.in
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