Immobilized Antimicrobial Agents: A Critical Perspective

Traditionally antimicrobial devices and applications have leveraged the elution of biocides from devices which were infused with these active molecules. The elution of these agents can, in some cases, limit the application of the device and can potentially lead to unwanted side effects. Following the ground breaking works of Isqueth, Abbott and Walters, surface immobilized antimicrobial agents (iAMA) have been explored. Devices sporting immobilized agents may remain active longer and minimize side effects. Researchers have examined the structure-activity of antimicrobial agents appropriate for immobilized applications. A great deal of effort goes into the design, synthesis, immobilization and characterization of the AMA’s, and yet it is common for the activity measurement to be off-the-shelf methods that are poorly aligned with the needs of immobilized agents. As a result, much time and effort is wasted developing structureactivity relationships based on questionable interpretations. The purpose of this review is to educate and guide researchers planning to develop immobilized antimicrobial agents. As such, the focus is not only to review the agents which have been immobilized, but also to highlight the key means of immobilization and importantly the activity testing methods.