Lipid-based nanocarriers as transformative treatment in tuberculosis: a systematic review of therapeutic efficacy

Despite advances in global medicine, tuberculosis (TB) remains a leading cause of mortality worldwide. The current TB regime is hampered by prolonged treatment duration that frequently results in poor patient adherence and suboptimal clinical outcomes. Lipid-based nanocarriers have emerged as a promising solution to these hurdles, supported by positive preclinical findings. This systematic review critically evaluates the therapeutic efficacy of these platforms and analyzes the interplay between antibacterial activity, protocols, and physicochemical characteristics.

Following a comprehensive search across four databases, 5,746 studies were identified up to February 2026. Data were extracted and reviewed using predetermined criteria via Rayyan software.

Lipid-based nanocarriers significantly enhanced antibacterial activity, with minimum inhibitory concentration reduced up to approximately four-fold for conventional drug and 52-fold for experimental compounds. In vivo analysis revealed that drug-loaded solid lipid nanoparticles exhibited five-fold higher efficiency in clearing the bacterial burden in lungs and spleen as compared to oral free drugs.

Lipid-based nanoparticles loaded with anti-TB drugs exhibited enhanced antibacterial efficacy in majority of the pre-clinical studies. Further standardization in methodology is required to support clinical translation.

www.crd.york.ac.uk/prospero identifier is CRD420251007329.