Antimicrobial and antifouling efficacy of urinary catheters impregnated with a combination of macrolide and fluoroquinolone antibiotics against Pseudomonas aeruginosa

Abstract

The incidence of catheter associated urinary tract infections (CAUTIs) is increasing worldwide. This study was designed to modify a biomaterial by impregnating a silicone urinary catheter with combination of a macrolide, azithromycin (AZM) and a fluoroquinolone, ciprofloxacin (CIP). Drug release profiles showed slow yet continuous release of antibiotics from catheters for one month. In vitro efficacy testing showed that group B catheters [3% (w v⁻¹) CIP + 6% (w v⁻¹) AZM] outperformed group A catheters [2% (w v⁻¹) CIP + 5% (w v⁻¹) AZM] by (1) showing larger zones of inhibition (>31 mm) compared to group A (<28 mm) for up to 30 days against Pseudomonas aeruginosa PAO1; (2) killing adhered bacteria in 24 h compared to 24–48 h in group A; (3) showing longer antimicrobial durability for four weeks; and (4) exhibiting a stable real-time shelf life of one year, suggesting that these catheters can be explored in clinical settings, especially in long-term CAUTI.

Keywords:

• Azithromycin
• ciprofloxacin
• catheter associated urinary tract infections
• Pseudomonas aeruginosa
• urinary catheter

Acknowledgements

The authors thank the Sophisticated Analytical Instrumentation Facility (SAIF), Panjab University, Chandigarh for their kind support with the scanning electron microscopy.

Supplemental data

The supplemental data for this paper is available online at http://dx.doi.org/10.1080/08927014.2016.1155564