A silicone ventricular catheter coated with a combination of rifampin and trimethoprim for the prevention of catheter-related infections.

So-called antiinfective catheters which are generated by incorporation of antimicrobial substances into polymers appear to be effectful devices in the prevention of catheter related infections. Such devices mainly act by prevention of bacterial colonization of the catheter surface rather than by inhibition of adherence. In a preceding study, we developed a rifampin-containing silicone catheter for the prevention of ventricular shunt infection. In the present study, this work was continued with a combination of antimicrobials incorporated in silicone ventricular catheters to reduce the risk of rifampin resistance and to expand the antimicrobial spectrum. We found that the drug release kinetics could be greatly influenced by the incorporation conditions. It was possible to incorporate an optimal antibiotic combination of rifampin and trimethoprim into the polymer resulting in defined release rates and a defined total release. A catheter loaded with this combination showed an excellent reduction of the colonization with Staphylococcus aureus (99.97% reduction within 3 hours) under in-vitro conditions.