Interest in antimicrobial coatings and additives for a range of medical devices has exploded in recent years as medical device manufacturers attempt to meet end-user demand for products that reduce the risk of hospital-acquired infections (HAIs). But could antimicrobials be doing more harm than good?
Len Czuba, president of product design and development firm Czuba Enterprises, thinks that may be the case. At the MEDevice Forum in San Diego last month, Czuba, who chaired a conference on biomaterials, responded to a question about antimicrobials from the audience by stating that he wasn't on the antimicrobials bandwagon. "The reason I'm not in favor of them is because I believe that people need to use aseptic techniques when infusing a drug or making a connection," he says. "And if we tell [users] that this product is antimicrobial, does that lead to a little bit less care being taken? I think it does, and that people don't really understand how it's used."
Czuba elaborated on this statement, citing antimicrobials' origins in children's toys and furniture as a cautionary tale. He notes that these early antimicrobial-equipped products were marketed in a manner that implied that they were impenetrable to bacteria, which, in turn, perhaps prompted parents to be more lax with toy cleanliness. However, the amount of antimicrobial agent applied to these products, in reality, could not feasibly keep surfaces completely free of bacteria over the long haul, according to Czuba. "I think it implied much more than it delivered. I think that's why we're not seeing antimicrobials too widely used in consumer products these days."
But is the medical device industry, likewise, promising more than it's delivering? Czuba presents a valid argument against the use of antimicrobial technologies in medical applications. Similar to the toy industry, the medical device industry is undeniably getting caught up in the antimicrobial hype. It also seems reasonable that end-users may not be quite as vigilant with medical products if they believe that they have some sort of safety net.
And yet, I'm not totally convinced that antimicrobials are ultimately doing more damage than good--in medical device applications, at least. The high incidence of HAIs, coupled with their associated costs, recovery time, and threat to patients, merits continued use of antimicrobials, particularly in catheters and other such bacteria-vulnerable devices.
That said, I do think that companies should carefully consider Czuba's stance on antimicrobials and the possibility that painting antimicrobials as a panacea can unintentionally breed irresponsibility or laziness among end-users. "Be careful when you adopt antimicrobial [technologies] because your customers are going to ask for it, your development staff is going to say 'we should do this,' and the marketing teams will say we need it," Czuba cautions. "We have to be real careful about what we promise and what we deliver for antimicrobials." Regardless of your position on antimicrobials, Czuba's parting words are sound advice.