The research area of antimicrobial surface coatings really started to take off around 2000, So the idea of incorporating antimicrobials onto the surface of medical devices is not a new one.
With more than 16 years’ research now, only a handful of products have made it into the clinic with the goal of saving lives by combating infectious agents that colonize surfaces. Their usage is not very wide-spread. But why is this so?
It is helpful to take as an example the most well-known antimicrobial products which are based on silver. One criticism is that the antimicrobial mechanism of silver is very broad — based on electrostatic interactions — and there is potential for interference with the biochemical machinery not only for pathogens but also for host cells. This idea of selectivity (harming only pathogens and not host cells) is exactly why when you go to a doctor to fight a nasty bacterial infection, you get an effective and approved antibiotic drug, and not a glass of silver nanoparticles.
So surfaces that incorporate antibiotic drugs may be promising for their ability to kill or inhibit microbial colonisation and have a well-known window of safety approved for their use.
Our latest publication on this topic is a mini-review called “Anti-infective Surface Coatings: Design and Therapeutic Promise against Device-Associated Infections”. Published in the open access journal PLOS Pathogens, the review is called a Pearl (i.e. “pearls of wisdom”) following the editorial guidance that it should be a “lesson that lasts”.
Our “Pearl” gets to the promises and pitfalls, as seen in a few literature examples, of how to best interface antibiotic surface coatings with pathogens. While there have been some innovative solutions, we are still a long way off from developing implantable devices that are both effective and compatible with the host. Will this take another 16 years until we see such devices enter the market? Probably not. An acceleration is taking place with nearly one paper published every day on the broad topic. We point out that the nexus between promise and pitfall is likely to narrow with a greater emphasis on collaboration between materials scientists, microbiologists, and clinicians. Indeed, in our own work, as can be seen by the co-authors on the paper, assembling a team with interdisciplinary skill sets is likely to create advances in this area.
Coad BR, Griesser HJ, Peleg AY, Traven A (2016) Anti-infective Surface Coatings: Design and Therapeutic Promise against Device-Associated Infections. PLoS Pathog 12(6): e1005598. doi:10.1371/journal.ppat.1005598