Chlorhexidine sustained-release varnishes for catheter coating – Dissolution kinetics and antibiofilm properties

Gefter, Julia; Zaks, Batia; Kirmayer, David; Lavy, Eran; Steinberg, Doron; Friedman, Michael

doi:10.1016/j.ejps.2017.10.041

Cited by 27 publications

(23 citation statements)

References 26 publications

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“…Over the past few decades, researchers have designed and obtained approval for antibiotic-coated urinary catheters for use in clinical settings. However, due to the higher cost and contradictory results from in vitro studies and in clinical trials, their efficacy is brought into question [4,25,63,74,77,79,91,[102][103][104][105][106][107][108][109][110][111][112][113]. The most common antibiotics used include nitrofurazone, gentamicin, fluoroquinolones (norfloxacin, ciprofloxacin, sparfloxacin), triclosan, and chlorhexidine.…”

Section: Antibioticsmentioning

confidence: 99%

“…Nevertheless, since there has been no data in humans that shows triclosan leading to antimicrobial resistance, the benefits have compensated for the cost [113]. However, recently researchers have reported triclosan promotes antibiotic tolerance in bacteria both in vitro and in vivo [109,122,123], which fuels the controversy over the efficacy and use of triclosan.…”

Section: Triclosanmentioning

confidence: 99%

“…Chlorhexidine is a bacteriostatic molecule at low levels, but at high levels, it is considered bactericidal [124]. Chlorhexidine has a variety of effects on both bacteria and fungi but has a relatively low toxicity in mammals and is commonly used to wash materials and maintain aseptic conditions when placing a urinary catheter [63,109]. Studies have tested the effectiveness of chlorhexidine when used to rinse out the bladder during catheterization to prevent microbial colonization and found it to be very effective when compared to saline washes [110].…”

Section: Chlorhexidinementioning

confidence: 99%

“…The varnish showed a peak in release in the first few hours, then a slow release for the 24 h tested. More importantly, when the chlorhexidine imbedded matrix was submerged in fresh P. aeruginosa inoculum every 24 h for 3 days, the first 2 days showed a significant decrease in bacterial adhesion to the catheter compared to an un-embedded matrix [109]. This study was performed following promising results in vivo to characterize the release of chlorhexidine.…”

Section: Chlorhexidinementioning

confidence: 99%

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Urinary Catheter Coating Modifications: The Race against Catheter-Associated Infections

Andersen

Flores-Mireles

2019

Coatings

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Urinary catheters are common medical devices, whose main function is to drain the bladder. Although they improve patients' quality of life, catheter placement predisposes the patient to develop a catheter-associated urinary tract infection (CAUTI). The catheter is used by pathogens as a platform for colonization and biofilm formation, leading to bacteriuria and increasing the risk of developing secondary bloodstream infections. In an effort to prevent microbial colonization, several catheter modifications have been made ranging from introduction of antimicrobial compounds to antifouling coatings. In this review, we discuss the effectiveness of different coatings in preventing catheter colonization in vitro and in vivo, the challenges in fighting CAUTIs, and novel approaches targeting host-catheter-microbe interactions.

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Section: Antibioticsmentioning

confidence: 99%

Section: Triclosanmentioning

confidence: 99%

Section: Chlorhexidinementioning

confidence: 99%

Section: Chlorhexidinementioning

confidence: 99%

See 2 more Smart Citations

Urinary Catheter Coating Modifications: The Race against Catheter-Associated Infections

Andersen

Flores-Mireles

2019

Coatings

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“…To study the in vitro release kinetics of an active compound from a urinary medical device, release assays are predominantly carried out under sink conditions, that is, with sufficient solution to allow for complete dissolution or release, usually under shaking. Nevertheless, testing catheter specimens connected to flow systems is also an important approach . Under sink conditions, the test device or device segment is immersed in a fluid with daily replacement of the fluid.…”

Section: Materials Characterization For Evaluation Of Antimicrobial Omentioning

confidence: 99%

Evaluating Efficacy of Antimicrobial and Antifouling Materials for Urinary Tract Medical Devices: Challenges and Recommendations

Ramstedt

Ribeiro

Bujdáková

et al. 2019

Macromolecular Bioscience

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Device-Associated Urinary Tract InfectionsUrological devices are divided into several different market segments managing, for example, urinary incontinence, urinary stones, treatment of prostate hyperplasia or cancer, and erectile dysfunction. Devices aimed to manage urinary incontinence or maintain the ureter or urethra open and unobstructed, include ureteral stents for the upper urinary tract, urethral stents for the lower urinary tract, and urinary catheters. The focus of this paper is on catheter-and ureteral stent-associated UTI (Figure 1) as these are the major device groups and give rise to large numbers of infections worldwide. [10] In this review,

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Future Directions for Ureteral Stent Technology: From Bench to the Market

Domingues

Pacheco

Cruz

et al. 2021

Advanced Therapeutics

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Ureteral stents are broadly used for the treatment of a wide range of pathologies, with different complexities and characteristics. Despite being efficient, the morbidity associated with stents, such as bacterial infection and pain, limits their therapeutic action and often represents an increase in healthcare costs. As no single solution fits all problems, there is still a need to improve these medical devices. Throughout this review, the most recent innovations are outlined and suggestions regarding future directions for ureteral stent technology are formulated with respect to materials, coatings, and designs of these devices. As highlighted here, during the process of passing these innovations to the growing market of ureteral stents, one of the biggest challenges is to increase the predictive value of the in vitro assays and, consequently, reduce the number of in vivo tests needed. Thus, recommendations concerning in vitro standard testing of these devices are provided, with focus on medium, flow conditions, and microbiological parameters. Additionally, the reader is also presented with insights about a crucial but rarely discussed topic, the bureaucratic part of the bench to market process, particularly the product certification legislation in Europe.

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Chlorhexidine sustained-release varnishes for catheter coating – Dissolution kinetics and antibiofilm properties

Cited by 27 publications

References 26 publications

Urinary Catheter Coating Modifications: The Race against Catheter-Associated Infections

Urinary Catheter Coating Modifications: The Race against Catheter-Associated Infections

Evaluating Efficacy of Antimicrobial and Antifouling Materials for Urinary Tract Medical Devices: Challenges and Recommendations

Future Directions for Ureteral Stent Technology: From Bench to the Market

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