Table 2.
Summary of Advantages and Limitations of Polymeric Antimicrobial Biomaterials from the Past Decade Designed for Orthopedic Implant-Associated Infection Applications
| polymers: natural and synthetic | |||||
|---|---|---|---|---|---|
| composition | tested in vivo? | antimicrobial activity | advantages | limitations | ref |
| chitosan sponges | yes | 7–21 days activity zone of inhibition | (1) tunable delivery kinetics | (1) may require antibiotic supplement | 83 |
| (2) intrinsic activity | (2) limited duration of activity | ||||
| (3) biocompatibility | |||||
| collagen sponges | yes | 3–4log10 decrease bacterial CFUs | (1) biocompatibility | (1) require antibiotics | 86 |
| (2) limited duration of activity | |||||
| poly(lactic acid) diol and poly(caprolactone) diol coated polyethylene terephthalate | yes | up to 66 days activity (in vitro) and 20 days activity (in vivo) zone of inhibition | (1) tunable delivery kinetics | (1) require antibiotics | 87 |
| (2) limited duration of activity | |||||
| poly(l-lactic)acid coated poly(d,l-lactide-co-lactide) | no | not evaluated | (1) tunable delivery kinetics | (1) require antibiotics | 88 |
| (2) limited duration of activity | |||||
| poly(d-l-lactide) coating | no | inhibit adhesion 60% bacteria | (1) tunable delivery kinetics | (1) require antibiotics | 89 |
| (2) limited duration of activity | |||||
| micropatterned silicone | yes | inhibit adhesion of >90% bacteria | (1) intrinsic activity | (1) short range of antimicrobial action (only prevent bacterial attachment to surface) | 41 |
| (2) long-lasting | |||||
| xerogel coating (silane-based) on silicone | yes | 82% reduction implant infection (in vivo) | (1) intrinsic activity | (1) limited duration of activity | 135 |
| sulfonated poly(ether ether ketone) | yes | bacterial clearance of 80–100% CFUs | (1) promote osteogenesis | (1) limited duration of activity | 112 |
| (2) durability | |||||
| cross-linked PEG | yes | bacterial clearance of 100% CFUs | (1) injectable (minimally invasive application) | (1) limited duration of activity | 120 |
| poly (ethylene imine)/poly(sodium-4-styrenesulfonate)/poly(allylamine hydrochloride) | no | inhibit adhesion 80% bacteria | (1) local drug synthesis | (1) cytotoxicity of poly(ethylenimine) | 121 |