Nanocarrier Systems for Nystatin Delivery: Formulation Performance and Therapeutic Implications in Candidiasis Treatment.

Nystatin is a commonly used antifungal medicine for the treatment of candidiasis, particularly in superficial and mucosal infections. Its clinical usefulness is limited by poor water solubility, instability, a short residence time in the mucosa, and low absorption. This review critically evaluates 22 eligible studies (PRISMA 2020-compliant search, January 2004-December 2025) on nano- and microparticulate delivery systems for nystatin in the treatment of candidiasis, using a novel analytical framework that maps nanocarrier physicochemical properties to site-specific delivery requirements across oral, cutaneous, and vulvovaginal candidiasis. Nanoemulsions, nanosuspensions, Solid Lipid Nanoparticles (SLN), Nanostructured Lipid Carriers (NLC), polymeric nanoparticles, and vesicular systems, specifically liposomes and nanocubosomes, are evaluated by standardized physicochemical parameters, evidence-graded antifungal endpoints, and a translational readiness evaluation. Nanoemulsions and NLCs demonstrate the most favorable translational profiles. Challenges related to manufacturing scalability, long-term stability, and regulatory acceptance remain barriers to clinical translation.