cefoxitin and tridodecylmethylammonium

Previous in vitro, in vivo, and a preliminary clinical report have demonstrated efficacy of noncovalently bonding antibiotics to the surface of continuous ambulatory peritoneal dialysis (CAPD) catheters in decreasing infectious complications. A larger prospective randomized clinical trial was completed. Eighty-six patients with chronic renal failure were enrolled in the study and randomized to receive either a surfactant treated or untreated control catheter. All catheters were soaked in cefoxitin at the time of insertion. Groups were comparable in terms of pre-existing illnesses, age, and gender. No differences were shown in the incidence of catheter-tract infections, peritonitis or mechanical complications. There was also no differences in microbiologic culture results. Therefore, it is concluded that this clinical trial did not demonstrate a reduction in catheter-related infectious complications by antibiotic bonding.

Topics: Bacterial Infections; Catheters, Indwelling; Cefoxitin; Female; Humans; Male; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Prospective Studies; Quaternary Ammonium Compounds; Surface-Active Agents

Cefoxitin was bound to a microporous polytetrafluoroethylene (PTFE) surface with tridodecylmethylammonium chloride (TDMAC). Bactericidal concentrations of cefoxitin were achieved with very small doses of the antibiotic. Elution of cefoxitin from microporous PTFE occurs by two concurrent first-order processes, each occurring at a different rate constant. Bound cefoxitin inhibits the growth of Staphylococcus aureus in a bioassay. Finally, cefoxitin can be adsorbed to TDMAC-treated microporous PTFE in vivo when the antibiotic is administered locally or intravenously. The application of antibiotic bonding to the prevention of vascular prosthetic infections is discussed.

Topics: Animals; Blood Vessel Prosthesis; Cefoxitin; Chemical Phenomena; Chemistry; Polytetrafluoroethylene; Prostheses and Implants; Quaternary Ammonium Compounds; Rats; Rats, Inbred Strains; Staphylococcus aureus; Surface Properties