Biotechnological Approaches to Biofilm-Targeted Antifungal Therapy in Recurrent Vulvovaginal Candidiasis.

Recurrent Vulvovaginal Candidiasis (RVVC) is increasing worldwide, with biofilm persistence and antifungal resistance limiting treatment options. The combined use of antifungal treatments with antibiofilm agents has become a promising strategy. This review explores advanced therapeutic approaches, their limitations, and prospects. Overgrowth of vaginal Candida inflames the mucosa, causing itching, dryness, and whitish discharge. Biofilm formation worsens the condition, contributing to treatment failure, resistance, and recurrence. Conventional antifungal modalities are often inadequate against these multidimensional biofilm assemblies. Combining natural and synthetic antifungal agents with antibiofilm adjuncts has shown improved outcomes by targeting Candida cells within biofilms. This review compiles studies on multicomponent approaches to managing vaginal Candida infections, focusing on pan-Candida species to clarify species-specific resistance and persistence. Host factors in non-virgin women, a highly affected population, are examined alongside regional data on recurrence and treatment failure. Together, these insights highlight the microbiology of Candida biofilms, host and regional influences, and the socio-economic burden of RVVC, while emphasising the translational importance of combination therapy and biotechnology-driven innovations such as molecular docking, nanocarriers, CRISPR-based gene modulation, and engineered probiotics.